Serum irisin useful as early biomarker for predicting gestational diabetes later in pregnancy: Study
Odisha: A recent study has suggested the utility of serum irisin as a biomarker for predicting the development of gestational diabetes mellitus (GDM) between 24–28 weeks of pregnancy in high-risk patients. The study appears in the Indian Journal of Endocrinology and Metabolism.
Gestational diabetes is defined as any degree of glucose intolerance that is diagnosed first in the second or third trimester of pregnancy and is not clearly either preexisting type 1 or type 2 diabetes.
GDM is shown to be associated with several adverse maternal and paternal outcomes. Thus, early diagnosis is important for preventing maternal and neonatal complications. There is no good validation of bio-markers predicting GDM during the first trimester. Serum irisin in the first trimester has been proposed as a bio-marker to be linked to the later GDM development during 24–28 weeks of pregnancy.
Against the above background, Padala Ravi Kumar, Department of Endocrinology, MKCG Medical College and Hospital, Odisha, India, and colleagues aimed to investigate the role of serum irisin during early pregnancy to predict the development of GDM at 24–28 weeks in high-risk patients in a prospective study.
The study was performed among the pregnant women who were attendees of the Department of Endocrinology and antenatal clinic of the Department of Obstetrics and Gynecology of MKCG Medical College for a period of one year. They had at least one risk factor for GDM development.
Collection of the blood samples was done for the measurement of serum insulin, fasting plasma glucose, serum irisin, lipids (TC, LDL, HDL, TG), and HbA1c. 75 g of glucose was used for performing oral glucose tolerance tests during the first trimester and between 24-28 weeks of pregnancy.
Based upon IADPSG criteria at 24-28 weeks, patients were diagnosed as GDM. For predicting GDM between 24-28 weeks, serum irisin, glycemic parameters, and homeostatic model assessment of insulin resistance during the first trimester were analyzed.
Based on the study, the researchers found the following:
- Sixty-five patients were included in the study, out of which 20 (30.8%) patients developed GDM and the rest 45 patients had normal glucose tolerance (NGT).
- The first trimester mean serum irisin concentration was significantly lower in women who later developed GDM compared with women who had NGT (111.65 ± 25.43 μg/L vs 185.89 ± 28.89 μg/L).
- Serum irisin concentration was the best predictor with an optimal threshold value of 149 μg/L, which had sensitivity, specificity, positive predictive value, and negative predictive value of 90%, 91.1%, 81.8%, 95.3%, respectively, for predicting GDM at 24–28 weeks of pregnancy.
The researchers wrote, "we consider serum irisin as a biomarker for GDM in early pregnancy as it had shown a significantly greater ability to predict GDM early as compared to other parameters."
Reference:
Sahoo, Devadarshini; Pattanaik, Sudhi Ranjan; Kumar, Padala Ravi,; Gandhi, Ronak Role of Serum Irisin During Early Pregnancy to Predict The Development of Gestational Diabetes Mellitus at 24–28 Weeks of Pregnancy in high-risk patients, Indian Journal of Endocrinology and Metabolism: Jan–Feb 2022 - Volume 26 - Issue 1 - p 61-67 doi: 10.4103/ijem.ijem_466_21
