1.Total sialic acid and other inflammatory markers as predictors of gestational diabetes.
Maria Leonora Del Rosario CAPELLAN ; Augusto D. LITONJUA ; Josephine Carlos RABOCA
Philippine Journal of Internal Medicine 2009;47(1):11-17
BACKGROUND: Total sialic acid determination has been show as an inflammatory marker for type 2 diabetes. No Local study has been done characterize the levels of TSA in gestational diabetes.
OBJECTIVES: To determine inflammatory markers predictive of gestational diabetes; to be able to describe the clinical profile of subjects enrolled in this study and determine the odds ratio for each inflammatory marker
STUDY DESIGN AND METHODOLOGY: Sixty two pregnant patients in their first trimester were included in this study. Inflammatory markers wre measured at 12 weeks and repeated at 24-28 weeks AOG together with screening glucose tets include random sugar at 12 weeks and 75-gram oral glucose tolerance test at 24-28 weeks. Factors independently associated with impaired glucose tolerance (IGT) and gestational diabetes mellitus(GDM) were determined using logistic regression stepwise model technique.
RESULTS: Of the 62 pregnant patients in their first trimester enrolled in study, five were diagnosed to have GDM based on the American Diabetes Association criteria(ADA), four with IGT and 53 with normal glucose tolerance. At 12 weeks gestation, total sialic acid (TSA) was higher among those with IGT and GDM compared to those with normal glucose tolerance (NGT) (mean=241.5 vs 175 vs 161. p=.030). However it was higher in GDM than those with IGT and NGT at 24-28 weeks (mean= 244.8 vs 229.7 vs 177, p = .025). Deranged total sialic acid performed at 24-28 weeks showed a trend for association with gestational diabetes (RR = 3.6, 95% CI 0-4.53, p=0.96). Other factors correlated, include a higher mean age (>26) and a family history of diabetes mellitus . Factors associated with impaired glucose tolerance, include a deranged TSA at 12 weeks, deranged CRP at 24-28 weeks , a deranged ESR both at 12 and 24-28 weeks gestation and a family history of diabetes mellitus.
CONCLUSION: Deranged levels of TSA at 24-28 weeks AOG seem to be associated wuth gestational diabetes. TSA determination at this gestational age can be utilized to screen gesttional diabetes.
Total Sialic Acid ; Gestational Diabetes ; Inflammatory Markers
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