Endocrine Abstracts

Background: Gestational diabetes mellitus (GDM) is a significant public health problem with a rising prevalence and a potential impact on maternal and foetal health outcomes. The diagnosis of GDM using the current gold standard of the 75g Oral Glucose Tolerance Test (OGTT) is fraught with many challenges. Studies have shown the potential of maternal gut peptides in diagnosing gestational diabetes.

Aim: The study aims to determine the potential utility of maternal gut peptides as diagnostic markers or screening tools for gestational diabetes mellitus (GDM).

Method: This diagnostic accuracy cross-sectional study compares the maternal gut peptides with the standard (75g OGTT) for screening women for GDM. The study recruited 215 pregnant women at high risk of GDM at 24-28 weeks gestation. The participants had GLP1, GIP, Ghrelin and peptide YY measured using the Sandwich-ELISA technique. Fetal and maternal outcomes were recorded at delivery. A receiver operating characteristic (ROC) curve was constructed to determine the ability to discriminate between GDM and non-GDM cases.

Results: The mean age of the 215 study participants was 30.59 years. Multiparous women (parity of 1 to 4) comprised 59.1%, and grand multipara were 34.0%. Mean Ghrelin and Peptide YY values at baseline were 461.36±319.38, 41.93±33.15 and 459.91±189.23, 105.57±159.18, pmol/l, respectively. At 0 minutes (basal), only ghrelin showed a statistically significant area under the curve of 0.925, p-value <0.001, with a sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic accuracy of 81.8%, 26.3%, 3.11, 0.25, and 0.850, respectively. At 120 mins, ghrelin and peptide YY showed an AUC of 0.882 and 0.830, a sensitivity of 85.7% and 81.0%, and a sensitivity of 19.1% and 25.0% with p values <0.001, respectively.

Conclusion and Major Recommendation: Ghrelin and peptide YY showed good potential as potential diagnostic markers for GDM.