Xia Hexia
Obstetrics and Gynecology Hospital of Fudan University, China
Title: Preconception sex-hormone binding globulin (SHBG) as a valuable predictor for gestational diabetes mellitus in infertile Chinese women with polycystic ovary syndrome
Biography
Biography: Xia Hexia
Abstract
We aim to elucidate whether preconception SHBG levels are predictive of GDM in women with PCOS. A prospective cohort study was conducted between January 2010 and December 2013 in Ob & Gyn Hospital of Fudan University. A total of 94 infertile Chinese women treated with ovulation induction were recruited and then prospectively followed up until 6 weeks after delivery. Serum SHBG levels before conception was measured. Diagnosis of GDM was based on a 2-hour, 75 g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks of gestation. We examined the incidence of GDM and plotted a receiver operating characteristic (ROC) curve to assess discrimination. We found that 31(32.98%) were diagnosed with GDM in the 94 pregnant PCOS women. The SHBG levels in women with GDM were (41.5±37.5) nmol/L, significantly lower than (123.7±95.7) nmol/L in those without GDM (P=0.000, and P= 0.041, even after BMI was adjusted). And the area of insulin under the curve (IAUC) in GDM group was (389.6±153.7) mIU/ml, significantly higher than (252.4±93.3) mIU/ml in the non-GDM group (P=0.000, and P= 0.003, even when BMI was adjusted). The area of SHBG and IAUC under the ROC was 80.8% (95% confidence interval [CI] 0.692- 0.925, P=0.000) and 0.786 (95% CI 0.656- 0.916, P=0.001). The optimal cut-off value for detecting GDM was a SHBG ≤37.26 nmol/l and an AIUC≥313.42 mIU/ml. SHBG associated with IAUC predicted the risk of GDM with a sensitivity and specificity of 77.8% and 77.5%. We concluded that SHBG levels before conception might be a valuable predictor of GDM in pregnant women with PCOS.