Sex-hormone-binding globulin early in pregnancy for the prediction of severe gestational diabetes mellitus and related complications
Journal of Obstetrics and Gynaecology Research, 05/23/2012
Caglar GS et al. – Sex–hormone–binding globulin (SHBG) is valuable for screening women early in pregnancy for GDM risk; however, a standard assay for analyses and a threshold level of serum SHBG for a constant gestational week has to be determined.
Methods- Among the participants (n = 93) who provided blood samples between 13 and 16 weeks gestation, 30 cases subsequently developed GDM. Complications and medical interventions were noted.
- The best cut–off point of SHBG and diagnostic performance were calculated.
- The mean age was 28.45 ± 5.0 years. SHBG levels were lower in the GDM group (n = 30) when compared with non–GDM (n = 63) cases (<0.01).
- Among the GDM women, SHBG was lower in the insulin therapy group (n = 15) compared with medical nutritional therapy alone (n = 15) (P < 0.01).
- A good predictive accuracy of SHBG was found for GDM requiring insulin therapy (area under the curve: 0.866, 95% confidence interval: 0.773–0.959).
- An SHBG threshold for 97.47 nmol/L had a sensitivity of 80.0%, specificity 84.6%, positive predictive value 50.0% and negative predictive value 95.7%.
- The calculated odds ratio for SHBG < 97.47 nmol/L was 12.346 (95% confidence interval: 1.786–83.33).
