Predictive significance of first trimester serum uric acid as risk factor for the gestational diabetes mellitus.
Keywords:First Trimester, Gestational Diabetes Mellitus, Predictive Significance, Serum Uric Acid
Objective: Determining the predictive significance of first trimester serum uric acid for the development of gestational diabetes mellitus (GDM) in pregnant women. Study Design: Case Control study. Setting: Department Gynecology and Obstetrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital Karachi. Period: March 2017 to December 2018. Material & Methods: Sample of 172 pregnant women in first trimester (<14 weeks gestation) were divided into; 72 controls and 72 cases through purposive sampling. Pregnant women with fasting blood glucose (FBG) ≥100 mg/dl were defined as GDM. FBG was estimated by hexokinase and uric acid by enzymatic method (uricase) using commercial colorimetric assay (Nikken Seal Co., Ltd, Japan). Data was analyzed on SPSS software 21.0 (IBM, Inc USA) at 95% CI. Results: Maternal age of control and cases was noted 30.23±1.47 and 30.14±1.41 years. Gestational age in controls was 9.80±2.23 weeks compared to 10.37±2.34 weeks in cases. Serum Uric acid in control was 3.19±0.49 mg/dl compared to 3.73±0.43 mg/dl in cases (P=0.0001). Logistic regression analysis model generated ROC curve shows excellent area under the curve (AUC) of 0.92 [95% CI (0.87-0.97)] with a diagnostic threshold of 3.91 mg/dl for uric acid. At this Uric acid threshold, the specificity and sensitivity was 96.4% and 69.7% respectively (P=0.0001). Conclusion: It is concluded first trimester serum uric acid may be used for predicting the future development of gestational diabetes mellitus.