A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study
Steroid hormones (SH) during pregnancy are associated with the development of gestational diabetes mellitus (GDM). Early and mid-Down syndrome screening is used to assess the risk of Down syndrome in the fetus. It is unclear whether changes in SH during this period can be used as an early predictor...
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| Veröffentlicht in: | Diabetes research and clinical practice 2024-11, Vol.217, p.111865, Article 111865 |
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| creator | Zhu, Bo Yin, Binbin Li, Hui Chu, Xuelian Mi, Zhifeng Sun, Yanni Yuan, Xiaofen Chen, Rongchang Ma, Zhixin |
| description | Steroid hormones (SH) during pregnancy are associated with the development of gestational diabetes mellitus (GDM). Early and mid-Down syndrome screening is used to assess the risk of Down syndrome in the fetus. It is unclear whether changes in SH during this period can be used as an early predictor of GDM.
This study was a multicenter, longitudinal cohort study. GDM is diagnosed by an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. We measured SH levels at early and mid-Down syndrome screening, respectively. Based on the SH changes, logistic regression analysis was used to construct a prediction model for GDM. Finally, evaluated the model’s predictive performance by creating a receiver operating characteristic curve (ROC) and performing external validation.
This study enrolled 193 pregnant women (discovery cohort, n = 157; validation cohort, n = 36). SH changes occur dynamically after pregnancy. At early Down syndrome screening, only cortisol (F) (p |
| doi_str_mv | 10.1016/j.diabres.2024.111865 |
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This study was a multicenter, longitudinal cohort study. GDM is diagnosed by an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. We measured SH levels at early and mid-Down syndrome screening, respectively. Based on the SH changes, logistic regression analysis was used to construct a prediction model for GDM. Finally, evaluated the model’s predictive performance by creating a receiver operating characteristic curve (ROC) and performing external validation.
This study enrolled 193 pregnant women (discovery cohort, n = 157; validation cohort, n = 36). SH changes occur dynamically after pregnancy. At early Down syndrome screening, only cortisol (F) (p < 0.05, 95 % CI 4780.95–46083.68) was elevated in GDM. At mid-Down syndrome screening, free testosterone (FT) (p < 0.01, 95 % CI 0.10–0.55) and estradiol (E2) (p < 0.05, 95 % CI 203.55–1784.78) were also significantly elevated. There were significant differences in the rates of change in E2 (Fold change (FC) = 1.3425, p = 0.0072), albumin (ALB) (FC=1.5759, p = 0.0117), and dihydrotestosterone (DHT) (FC=-2.1234, p = 0.0165) between GDM and no-GDM. Stepwise logistic regression analysis resulted in the best predictive model, including six variables (Δweight, ΔF, Δcortisone (E), ΔE2, Δprogesterone (P), ΔDHT). The area under the curve for this model was 0.791, and for the external validation cohort, it was 0.799.
A GDM prediction model can be constructed using SH measures during early and mid-Down syndrome screening.</description><identifier>ISSN: 0168-8227</identifier><identifier>ISSN: 1872-8227</identifier><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2024.111865</identifier><identifier>PMID: 39307357</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Diabetes, Gestational - blood ; Diabetes, Gestational - diagnosis ; Down Syndrome - blood ; Down Syndrome - diagnosis ; Down syndrome screening ; Estradiol - blood ; Female ; Gestational diabetes mellitus ; Glucose Tolerance Test ; Hormones - blood ; Humans ; Hydrocortisone - blood ; Longitudinal Studies ; Mass Screening ; Prediction model ; Pregnancy ; Steroid hormonal ; Steroids - blood ; Testosterone - blood</subject><ispartof>Diabetes research and clinical practice, 2024-11, Vol.217, p.111865, Article 111865</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c243t-d2148ee67d614cff4320677c89df9e2d4b4988976c6de7b2c9c8e95c467bb1023</cites><orcidid>0000-0002-4298-8788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.diabres.2024.111865$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39307357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Bo</creatorcontrib><creatorcontrib>Yin, Binbin</creatorcontrib><creatorcontrib>Li, Hui</creatorcontrib><creatorcontrib>Chu, Xuelian</creatorcontrib><creatorcontrib>Mi, Zhifeng</creatorcontrib><creatorcontrib>Sun, Yanni</creatorcontrib><creatorcontrib>Yuan, Xiaofen</creatorcontrib><creatorcontrib>Chen, Rongchang</creatorcontrib><creatorcontrib>Ma, Zhixin</creatorcontrib><title>A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study</title><title>Diabetes research and clinical practice</title><addtitle>Diabetes Res Clin Pract</addtitle><description>Steroid hormones (SH) during pregnancy are associated with the development of gestational diabetes mellitus (GDM). Early and mid-Down syndrome screening is used to assess the risk of Down syndrome in the fetus. It is unclear whether changes in SH during this period can be used as an early predictor of GDM.
This study was a multicenter, longitudinal cohort study. GDM is diagnosed by an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. We measured SH levels at early and mid-Down syndrome screening, respectively. Based on the SH changes, logistic regression analysis was used to construct a prediction model for GDM. Finally, evaluated the model’s predictive performance by creating a receiver operating characteristic curve (ROC) and performing external validation.
This study enrolled 193 pregnant women (discovery cohort, n = 157; validation cohort, n = 36). SH changes occur dynamically after pregnancy. At early Down syndrome screening, only cortisol (F) (p < 0.05, 95 % CI 4780.95–46083.68) was elevated in GDM. At mid-Down syndrome screening, free testosterone (FT) (p < 0.01, 95 % CI 0.10–0.55) and estradiol (E2) (p < 0.05, 95 % CI 203.55–1784.78) were also significantly elevated. There were significant differences in the rates of change in E2 (Fold change (FC) = 1.3425, p = 0.0072), albumin (ALB) (FC=1.5759, p = 0.0117), and dihydrotestosterone (DHT) (FC=-2.1234, p = 0.0165) between GDM and no-GDM. Stepwise logistic regression analysis resulted in the best predictive model, including six variables (Δweight, ΔF, Δcortisone (E), ΔE2, Δprogesterone (P), ΔDHT). The area under the curve for this model was 0.791, and for the external validation cohort, it was 0.799.
A GDM prediction model can be constructed using SH measures during early and mid-Down syndrome screening.</description><subject>Adult</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Down Syndrome - blood</subject><subject>Down Syndrome - diagnosis</subject><subject>Down syndrome screening</subject><subject>Estradiol - blood</subject><subject>Female</subject><subject>Gestational diabetes mellitus</subject><subject>Glucose Tolerance Test</subject><subject>Hormones - blood</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Longitudinal Studies</subject><subject>Mass Screening</subject><subject>Prediction model</subject><subject>Pregnancy</subject><subject>Steroid hormonal</subject><subject>Steroids - blood</subject><subject>Testosterone - blood</subject><issn>0168-8227</issn><issn>1872-8227</issn><issn>1872-8227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9u1DAYxC0EotvCI4B85JLF_2I7XNCqAopUiQucLcf-svUqsRc7odrH4U1xugtXTv5k_WZGo0HoDSVbSqh8f9j6YPsMZcsIE1tKqZbtM7ShWrFGM6aeo03l9NN9ha5LORBCJBftS3TFO04Ub9UG_d7hYwYf3BxSxFPyMOIhZbyHMtv1z454DYIZCp5gHMO8FNzbAh5XQZkhp-DxQ8rTE-sebKxaHCIGm8cTttHjKfjGp8eKn6LPaQJcXAaIIe4_4B2elnEODmL1wmOK-xrhw2pW6nF6hV4Mdizw-vLeoB-fP32_vWvuv335eru7bxwTfG48o0IDSOUlFW4YBGdEKuV054cOmBe96LTulHTSg-qZ65yGrnVCqr6nhPEb9O7se8zp51LrmykUVxvbCGkphlOiudaiXdH2jLqcSskwmGMOk80nQ4lZ1zEHc1nHrOuY8zpV9_YSsfQT-H-qv3NU4OMZgFr0V4BsigsQXR0og5uNT-E_EX8AJh2nCw</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Zhu, Bo</creator><creator>Yin, Binbin</creator><creator>Li, Hui</creator><creator>Chu, Xuelian</creator><creator>Mi, Zhifeng</creator><creator>Sun, Yanni</creator><creator>Yuan, Xiaofen</creator><creator>Chen, Rongchang</creator><creator>Ma, Zhixin</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4298-8788</orcidid></search><sort><creationdate>202411</creationdate><title>A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study</title><author>Zhu, Bo ; Yin, Binbin ; Li, Hui ; Chu, Xuelian ; Mi, Zhifeng ; Sun, Yanni ; Yuan, Xiaofen ; Chen, Rongchang ; Ma, Zhixin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c243t-d2148ee67d614cff4320677c89df9e2d4b4988976c6de7b2c9c8e95c467bb1023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Diabetes, Gestational - blood</topic><topic>Diabetes, Gestational - diagnosis</topic><topic>Down Syndrome - blood</topic><topic>Down Syndrome - diagnosis</topic><topic>Down syndrome screening</topic><topic>Estradiol - blood</topic><topic>Female</topic><topic>Gestational diabetes mellitus</topic><topic>Glucose Tolerance Test</topic><topic>Hormones - blood</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Longitudinal Studies</topic><topic>Mass Screening</topic><topic>Prediction model</topic><topic>Pregnancy</topic><topic>Steroid hormonal</topic><topic>Steroids - blood</topic><topic>Testosterone - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Bo</creatorcontrib><creatorcontrib>Yin, Binbin</creatorcontrib><creatorcontrib>Li, Hui</creatorcontrib><creatorcontrib>Chu, Xuelian</creatorcontrib><creatorcontrib>Mi, Zhifeng</creatorcontrib><creatorcontrib>Sun, Yanni</creatorcontrib><creatorcontrib>Yuan, Xiaofen</creatorcontrib><creatorcontrib>Chen, Rongchang</creatorcontrib><creatorcontrib>Ma, Zhixin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes research and clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Bo</au><au>Yin, Binbin</au><au>Li, Hui</au><au>Chu, Xuelian</au><au>Mi, Zhifeng</au><au>Sun, Yanni</au><au>Yuan, Xiaofen</au><au>Chen, Rongchang</au><au>Ma, Zhixin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study</atitle><jtitle>Diabetes research and clinical practice</jtitle><addtitle>Diabetes Res Clin Pract</addtitle><date>2024-11</date><risdate>2024</risdate><volume>217</volume><spage>111865</spage><pages>111865-</pages><artnum>111865</artnum><issn>0168-8227</issn><issn>1872-8227</issn><eissn>1872-8227</eissn><abstract>Steroid hormones (SH) during pregnancy are associated with the development of gestational diabetes mellitus (GDM). Early and mid-Down syndrome screening is used to assess the risk of Down syndrome in the fetus. It is unclear whether changes in SH during this period can be used as an early predictor of GDM.
This study was a multicenter, longitudinal cohort study. GDM is diagnosed by an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. We measured SH levels at early and mid-Down syndrome screening, respectively. Based on the SH changes, logistic regression analysis was used to construct a prediction model for GDM. Finally, evaluated the model’s predictive performance by creating a receiver operating characteristic curve (ROC) and performing external validation.
This study enrolled 193 pregnant women (discovery cohort, n = 157; validation cohort, n = 36). SH changes occur dynamically after pregnancy. At early Down syndrome screening, only cortisol (F) (p < 0.05, 95 % CI 4780.95–46083.68) was elevated in GDM. At mid-Down syndrome screening, free testosterone (FT) (p < 0.01, 95 % CI 0.10–0.55) and estradiol (E2) (p < 0.05, 95 % CI 203.55–1784.78) were also significantly elevated. There were significant differences in the rates of change in E2 (Fold change (FC) = 1.3425, p = 0.0072), albumin (ALB) (FC=1.5759, p = 0.0117), and dihydrotestosterone (DHT) (FC=-2.1234, p = 0.0165) between GDM and no-GDM. Stepwise logistic regression analysis resulted in the best predictive model, including six variables (Δweight, ΔF, Δcortisone (E), ΔE2, Δprogesterone (P), ΔDHT). The area under the curve for this model was 0.791, and for the external validation cohort, it was 0.799.
A GDM prediction model can be constructed using SH measures during early and mid-Down syndrome screening.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>39307357</pmid><doi>10.1016/j.diabres.2024.111865</doi><orcidid>https://orcid.org/0000-0002-4298-8788</orcidid></addata></record> |
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| ispartof | Diabetes research and clinical practice, 2024-11, Vol.217, p.111865, Article 111865 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Diabetes, Gestational - blood Diabetes, Gestational - diagnosis Down Syndrome - blood Down Syndrome - diagnosis Down syndrome screening Estradiol - blood Female Gestational diabetes mellitus Glucose Tolerance Test Hormones - blood Humans Hydrocortisone - blood Longitudinal Studies Mass Screening Prediction model Pregnancy Steroid hormonal Steroids - blood Testosterone - blood |
| title | A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study |
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