Relationship between serum uric acid in early pregnancy and gestational diabetes mellitus: a prospective cohort study

• Published in: Endocrine Vol. 83; no. 3; pp. 636 - 647
• Main Authors: Duo, Yanbei, Song, Shuoning, Zhang, Yuemei, Qiao, Xiaolin, Xu, Jiyu, Zhang, Jing, Peng, Zhenyao, Chen, Yan, Nie, Xiaorui, Sun, Qiujin, Yang, Xianchun, Wang, Ailing, Sun, Wei, Fu, Yong, Dong, Yingyue, Lu, Zechun, Yuan, Tao, Zhao, Weigang
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2024; Springer Nature B.V
• Subjects: Clinical trials; Creatinine; Diabetes; Diabetes mellitus; Endocrinology; Gestational diabetes; Glucose tolerance; Humanities and Social Sciences; Internal Medicine; Medicine; Medicine & Public Health; multidisciplinary; Original Article; Pregnancy; Pregnancy complications; Risk factors; Science; Uric acid; Gestational diabetes mellitus; Serum uric acid; Early pregnancy; Prospective study; Risk factor
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-023-03544-y

Purpose
The association between serum uric acid (UA) and gestational diabetes mellitus (GDM) was still unclear. Serum UA levels in pregnancy differed from that in non-pregnancy. This study aimed to investigate the changes of serum UA in early pregnancy, and to explore the association of serum UA with the risk of GDM.
Methods
A prospective double-center study including 873 singleton pregnant women was conducted in Beijing, China since 2019 (clinical trial number: NCT03246295). Seventy-eight healthy non-pregnant women were selected to compare the changes of biomarkers in pregnancy. Spearman correlation and logistic regression analysis were performed to measure the relationship between serum UA in early pregnancy and GDM.
Results
The incidence of GDM in our cohort was 20.27%(177/873). Compared with non-pregnant women, serum UA and creatinine decreased significantly during early pregnancy. Serum UA concentration in early pregnancy was significantly higher in GDM women than that in normal glucose tolerance (NGT) women [217.0(192.9, 272.0) μmol/l vs. 201.9(176.0, 232.0) μmol/l,
p
 < 0.001]. After adjusted for confounding factors, elevated serum UA remained as an independent risk factor for GDM. The risk of GDM increased when serum UA was above 240 μmol/l (adjusted OR 1.964, 95% CI 1.296–2.977,
p
 < 0.001), and stronger relationships between serum UA and GDM were observed in pregnant women aged over 35 years old and preBMI ≥ 24 kg/m
2
.
Conclusion
The normal range of serum UA and creatinine in pregnant women were lower than those in non-pregnant women. It is essential to monitor serum UA concentrations since early pregnancy to alert and prevent GDM, especially in older and heavier pregnant women.
Clinical trial number
NCT03246295.
Highlights
The levels of serum uric acid (UA) and creatinine in the first trimester of pregnant women were significantly lower than healthy non-pregnant women, probably because of the increase of glomerular filtration.
Serum UA concentration in the first trimester was significantly higher in women with gestational diabetes mellitus (GDM) than in women with normal glucose tolerance (NGT). The association of serum UA in the first trimester and GDM were observed when serum UA was above 240 μmol/l, and the association was stronger in women aged over 35 years old and preBMI ≥ 24 kg/m
2
.
To prevent GDM, healthy lifestyle intervention should be taken since early pregnancy to control serum UA concentration, especially in older and heavier pregnant women.