Prediction of gestational diabetes mellitus by use of homa-ir index and maternal plasma adiponectin concentration in the first trimester

Prediction Of Gestational Diabetes Mellitus by Use Of HOMA-IR Index and Maternal Plasma Adiponectin Concentration In The First TrimesterObjective: Prediction of gestational diabetes mellitus by use of maternal plasma adiponectin concentration and HOMA-IR index (homeostasis model assessment-insulin resistance) in the first trimesterMethod : 160 patients who were between the 11th and 14th week of gestation were included in the study. 8 (%5) patient who have not completed antenatal visits or patients who had intolerance to oral glucose test were excluded from the study. Statistical analysis performed for 152 patient. Adiponectin was meausered with radioimmunassay method. Fasting glucose and insulin measured and HOMA-IR index was calculated for each patient. Plasma adiponectin concentrations and HOMA-IR indexes were compared between the patients with normal glucose tolerance and who diagnosed as GDM for the of second trimester 100 gr. OGTT results.Results : Mean gestational age at sampling was 12.7±0.69 weeks. Plasma adiponectin concentrations were not significantly different (p= 0.255) between the two groups who diagnosed as GDM (n=14, % 9,2) and who had normal glucose tolerance (n=138, % 90.8). Fasting glucose (p<0.001) and insulin levels (p<0.001) and HOMA-IR (p<0.001) indexes were significantly higher in GDM group compared with the group of patients with normal glucose tolerance. Accepting a cut-off value of 2.93 for HOMA-IR index sensivity, specivity, positive predictive value and negative predictive value was %85.7, %95.7, %66,7 and %98.5, respectively.Conclusion : HOMA-IR index seems to be a good method to predict gestational diabetes mellitus in the first trimester of pregnancy.Key Words : Gestational diabetes mellitus, adiponectin, HOMA-IR, insulin resistance