Increased soluble (pro)renin receptor (s(P)RR) concentrations during the first trimester may predict the development of gestational diabetes mellitus (GDM) later in pregnancy, according to a study published in the June issue of the Journal of Clinical Endocrinology & Metabolism. With further validation, particularly in more diverse populations, s(P)RR holds the potential for filling a clinical gap in the screening of GDM early in pregnancy. With current screening methods, low-risk women with the potential to develop GDM are typically not identified until late second trimester, when low-risk women undergo a 50 gram, one-hour loading test, the glucose challenge test (GCT) at 24 weeks to 28 weeks of gestation. By contrast, in this study, women in the highest s(P)RR concentration quartile (over 34.2 ng/mL) during the first trimester were 2.90-fold more likely to develop GDM than women in the lowest quartile (less than 25.8 ng/ML). s(P)RR is a marker of activation of the tissue renin-angiotensin system, which is tied to adverse complications in patients with diabetes and hypertension. The researchers conducted a prospective study of 716 pregnant Japanese women who first visited a referral birth center at a tertiary hospital at less than 14 weeks of gestation between 2010 and 2011. A […]
Increased soluble (pro)renin receptor (s(P)RR) concentrations during the first trimester may predict the development of gestational diabetes mellitus (GDM) later in pregnancy, according to a study published in the June issue of the Journal of Clinical Endocrinology & Metabolism. With further validation, particularly in more diverse populations, s(P)RR holds the potential for filling a clinical gap in the screening of GDM early in pregnancy.
With current screening methods, low-risk women with the potential to develop GDM are typically not identified until late second trimester, when low-risk women undergo a 50 gram, one-hour loading test, the glucose challenge test (GCT) at 24 weeks to 28 weeks of gestation. By contrast, in this study, women in the highest s(P)RR concentration quartile (over 34.2 ng/mL) during the first trimester were 2.90-fold more likely to develop GDM than women in the lowest quartile (less than 25.8 ng/ML). s(P)RR is a marker of activation of the tissue renin-angiotensin system, which is tied to adverse complications in patients with diabetes and hypertension.
The researchers conducted a prospective study of 716 pregnant Japanese women who first visited a referral birth center at a tertiary hospital at less than 14 weeks of gestation between 2010 and 2011. A random blood glucose test (random time, regardless of the timing of the subject’s last meal) was administered during the first trimester (less than 14 weeks of gestation), while the 50 gram GCT was administered at 24 weeks to 28 weeks of gestation to determine candidates to undergo the 75 gram oral glucose tolerance test.
The researchers found that 44 participants (6.1 percent) had GDM. Only one woman was diagnosed with GDM from a random blood glucose test during the first trimester, with the remaining 43 women diagnosed after the GCT. Mean s(P)RR of the entire cohort was 30.6 ng/mL and was significantly higher in women with GDM than in women without GDM (35.5 ng/mL versus 30.3 ng/mL). The association between plasma s(P)RR concentrations and the onset of GDM was independent of GDM risk factors including baseline characteristics, medical complications, or gestational characteristics. Random blood glucose results did not differ significantly between women with and without GDM.
“Additional studies involving combinations with other risk factors and biomarkers, such as C-reactive protein, are warranted and may further improve the predictive ability of s(P)RR concentrations for GDM during early pregnancy,” write the authors, led by Noriyoshi Watanabe, from Tokyo Women’s Medical University (Japan).
