The use of biomarkers at the end of the second trimester to predict Gestational Diabetes Mellitus

•Metabolic and inflammatory biomarkers have been assessed previously for their role in the prediction of gestational diabetes mellitus (GDM).•Studies have focused on individual biomarkers with heterogeneity in terms of screening, GDM diagnostic criteria and glucose sample handling.•In this study, Insulin, C-peptide and leptin were associated with the development of GDM, (diagnosed with strict glucose sample handling).•However, there was confounding by maternal obesity and considerable overlap of biomarker concentrations.•This panel of biomarkers (alone or in combination) was not clinically useful for the early diagnosis of GDM. Previous studies that investigated the relationship between biomarkers and gestational diabetes mellitus (GDM) generally focused on individual biomarkers with significant heterogeneity in terms of the screening methodologies, diagnostic criteria for GDM and sample handling of glucose within these studies. This prospective study used an established panel of ten biomarkers to determine if they could predict the diagnosis of GDM. Women with risk factors for GDM were recruited at their first antenatal visit. They attended for an oral glucose tolerance test at 26–28 weeks’ gestation with strict preanalytical handling of glucose samples to minimise glycolysis. A fasting plasma sample taken simultaneously was stored at −80 °C and analysed in bulk for 10 biomarkers (insulin, c-peptide, glucagon, ghrelin, gastric inhibitory polypeptide (GIP), glucagon like peptide-1 (GLP-1), leptin, visfatin, resistin and plasminogen activator inhibitor-1 (PAI-1)) using the Bio-plex-pro Human Diabetes Assay. Insulin and C-peptide levels in the third tertile were associated with the development of GDM (adjusted odds ratio (aOR) 2.6, 95 % CI 1.3−5.0, p = 0.005 and aOR 3.7, 95 % CI 1.8−7.4, p