Diagnostic Utility of Extracellular Levels of Serum Amyloid P and Proteoglycan 4: A Case-Control Study in Gestational Diabetes Mellitus.

OBJECTIVE

Gestational diabetes mellitus (GDM) is linked to excessive inflammatory activation during pregnancy. Serum amyloid P component (SAP) and proteoglycan 4 (PRG4) participate in inflammatory and placental regulatory processes; however, their relationships with GDM remain insufficiently clarified. This exploratory single-center retrospective study aimed to preliminarily investigate the associations of circulating SAP and PRG4 concentrations with GDM.

METHODS

A total of 111 Pregnant women undergoing 24-28 week OGTT screening were enrolled and divided into the GDM group and normal glucose tolerance (NGT) group. Serum SAP and PRG4 levels were measured by ELISA. Baseline characteristics, biomarker concentrations and relevant clinical indices were compared between groups. Receiver operating characteristic (ROC) curve and logistic regression analyses were used to evaluate their associations and predictive value.

RESULTS

The median serum levels of proteoglycan 4 (PRG4) and serum amyloid P (SAP) were 1.81 (1.11, 2.60) ng/mL and 308.55 (227.06, 437.02) ng/mL, respectively. The serum SAP level in the GDM group [437.66 (366.69, 543.72) ng/mL] was significantly higher than that in the NGT group [232.22 (203.12, 295.86) ng/mL] (p<0.001). The AUC of SAP for predicting GDM was 0.886 (p<0.001). No significant difference in serum PRG4 levels was found between the two groups (p=0.111), with an AUC of 0.588 (p=0.111). Logistic regression analysis showed that serum SAP level ≥386.88 ng/mL was independently associated with GDM (odds ratio (OR)=3.292, 95% confidence interval (CI): 1.270-8.528, p=0.014); advanced maternal age (≥30 years), history of induced abortion and history of adverse pregnancy were also independent risk factors for GDM.

CONCLUSION

Elevated serum SAP may be correlated with GDM, whereas peripheral PRG4 showed no obvious association with gestational hyperglycemia in this cohort.