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Z Geburtshilfe Neonatol 2022; 226(06): 384-390
DOI: 10.1055/a-1936-0863
Original Article

Predictive and Prognostic Value of Plasma Zonulin for Gestational Diabetes Mellitus in Women at 24–28 Weeks of Gestation

Zehra Yilmaz
1   Department of Obstetrics and Gynecology, Medical Park Hospitals Group, Istanbul, Turkey
,
Serkan Oral
2   Department of Obstetrics and Gynecology, Halic University, Beyoglu, Turkey
,
Nazan Yurtcu 
3   Department of Obstetrics and Gynecology, Sivas Cumhuriyet University, Sivas, Turkey
,
Yasam Kemal Akpak
4   Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital Clinics, Izmir, Turkey
,
Sebahattin Celik
5   Department of Obstetrics and Gynecology, Balikesir State Hospital, Balikesir, Turkey
,
Canan Caliskan
6   Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
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Abstract

Objective We aimed to examine the predictive and prognostic value of plasma zonulin for gestational diabetes mellitus (GDM) in women at 24–28 weeks of gestation.

Methods This retrospective study was carried out with pregnant women with GDM (n=98) and normal glucose tolerance (control group) (n=132). GDM was diagnosed according to American Diabetes Association (ADA) criteria with a one-step 75-g OGTT at 24–28 gestational weeks. Their serum zonulin levels measured during one-step 75-g OGTT and perinatal outcomes were compared, and the cut-off value of plasma zonulin for the prediction of GDM was calculated with receiver operating characteristic curve analysis.

Results Plasma zonulin level was significantly higher in women with GDM compared to controls (28.8±24.9 and 7.3±11.3 ng/mL, respectively). According to logistic regression analysis, plasma zonulin levels and GDM were statistically significant. The plasma zonulin cut-off value was>45.2 ng/mL. The rate of cesarean section, the rate of meconium in the amniotic fluid, and the need for admission to the neonatal intensive care unit significantly differed between women with GDM and controls.

Conclusion In pregnant women with GDM, plasma zonulin increases, and with the cut-off level of>45.2 ng/mL, it can predict GDM with values of sensitivity and specificity levels significantly higher in pregnant women with GDM, suggesting that it can be used as a tool for its screening and early diagnosis.

Key words

gestational diabetes mellitus - zonulin - perinatal outcome - prediction - biomarker


Publication History

Received: 17 July 2021

Accepted after revision: 30 August 2022

Article published online:
10 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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