Value of serum 25 (OH) D3, IGFBP-3 and BALP levels in early pregnancy in predicting osteoporosis in patients with gestational diabetes mellitus
10.3760/cma.j.cn115807-20241230-00398
- VernacularTitle:孕早期血清25（OH）D3、IGFBP-3及BALP水平预测妊娠期糖尿病患者骨质疏松的价值
- Author:
Hua LIU
1
;
Min WANG
;
Yan LI
Author Information
1. 延安大学附属医院产科，延安 716000
- Publication Type:Journal Article
- Keywords:
Early pregnancy;
25-hydroxyvitamin D3;
Insulin-like growth factor binding protein 3;
Bone alkaline phosphatase;
Gestational diabetes mellitus;
Osteoporosis
- From:
Chinese Journal of Endocrine Surgery
2025;19(2):257-261
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of serum levels of 25-hydroxyvitamin D [25 (OH) D], insulin-like growth factor-binding protein 3 (IGFBP3) , and bone alkaline phosphatase (BALP) for osteoporosis (OP) in patients with gestational diabetes mellitus (GDM) during early pregnancy.Methods:A total of 201 patients with gestational diabetes mellitus (GDM) from the Department of Obstetrics at Yan'an University Affiliated Hospital between May. 2021 and May. 2024 were enrolled. According to the occurrence of osteoporosis (OP) , they were divided into the OP group (23 patients) and the non-OP group (178 patients) . Data on IGFBP3, BALP, osteocalcin (OC) , 25 (OH) D, interleukin-6 (IL-6) , calcium (Ca) , phosphorus (P) , β-collagen specific sequence (β-CTX) , type I collagen amino-terminal propeptide (PINP) , N-terminal osteocalcin (N-MID) , and bone mineral density (BMD) were collected. Pearson correlation analysis was performed for the triple relationship among 25 (OH) D3, IGFBP-3, and BALP. Univariate and multivariate analyses identified risk factors for OP in GDM patients. Locally-weighted scatter plot smoothing (Lowess) curves analyzed the relationship between these markers and OP occurrence, while ROC curves evaluated their predictive efficacy.Results:The OP incidence was 11.44%. Significant differences were observed between the two groups in family history, milk intake, calcium supplementation, 25 (OH) D3, IGFBP-3, BALP, BAP, OC, and IL-6 ( χ2=0.64, 9.74, 6.61, t=13.29, 18.22, 10.02, 4.21, 5.00, 6.67, P<0.001) . There was a significant positive correlation between 25 (OH) D3, IGFBP-3, and BALP levels. Univariate analysis revealed that family history, milk intake, calcium supplementation, BALP, BAP, OC, IGFBP3, 25 (OH) D3, and IL-6 were closely related to OP occurrence. Multivariate analysis showed decreased levels of 25 (OH) D3, IGFBP-3, and BALP increased OP risk. Combined ROC analysis indicated higher predictive efficacy for OP development compared to individual tests. Conclusions:Serum levels of 25 (OH) D3, IGFBP-3, and BALP are significantly and negatively correlated with OP incidence in GDM patients, acting as independent protective factors. Additionally, pairwise positive correlations exist among these markers.
