Circulating glycated albumin levels and gestational diabetes mellitus

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is characterized by glucose intolerance that is first diagnosed during pregnancy, making it the most common complication associated with this period. Early detection and targeted treatment of GDM can minimize foetal exposure to maternal hyperglycaemia and subsequently reduce the associated adverse pregnancy outcomes. Previous studies have inconsistently suggested that the level of glycated albumin (GA) might predict GDM.

AIM

To review and synthesize existing evidence to evaluate the relationship between GA levels and the development of GDM.

METHODS

We sought to compare GA levels between GDM and control groups in this meta-analysis by systematically searching the Web of Science, PubMed, Cochrane Library, and Embase databases for articles published up to June 2023. The analysis utilized the weighted mean difference (WMD) as the primary metric. The data were meticulously extracted, and the quality of the included studies was assessed. Additionally, we conducted a subgroup analysis based on study region and sample size. We assessed heterogeneity using I² statistics and evaluated publication bias through funnel plots. Additionally, trim-and-fill analysis was employed to detect and address any potential publication bias.

RESULTS

The meta-analysis included a total of 11 studies involving 5477 participants, comprising 1900 patients with GDM and 3577 control individuals. The synthesized results revealed a notable correlation between elevated GA levels and increased susceptibility to GDM. The calculated WMD was 0.42, with a 95% confidence interval (95%CI) ranging from 0.11 to 0.74, yielding a P value less than 0.001. Concerning specific GA levels, the mean GA level in the GDM group was 12.6, while for the control group, it was lower, at 11.6. This discrepancy underscores the potential of GA as a biomarker for assessing GDM risk. Moreover, we explored the levels of glycated haemoglobin (HbA1c) in both cohorts. The WMD for HbA1c was 0.19, with a 95%CI ranging from 0.15 to 0.22 and a P value less than 0.001. This observation suggested that both GA and HbA1c levels were elevated in individuals in the GDM group compared to those in the control group.

CONCLUSION

Our meta-analysis revealed a substantial correlation between elevated GA levels and increased GDM risk. Furthermore, our findings revealed elevated levels of HbA1c in GDM patients, emphasizing the significance of monitoring both GA and HbA1c levels for early GDM detection and effective management.

Keywords: Glycated albumin; Gestational diabetes mellitus; Diabetes mellitus; Meta-analysis; Weighted mean difference

Core Tip: The aim of this investigation was to elucidate the relationship between glycated albumin (GA) levels and the development of gestational diabetes mellitus (GDM), a prevalent gestational complication characterized by glucose intolerance. Emphasizing the importance of early diagnosis and intervention, this study used a meta-analytical approach to consolidate existing evidence, thereby performing a comprehensive examination of GA as a potential biomarker for GDM. By aggregating data from diverse studies, this research not only corroborated the association of elevated GA levels with increased GDM risk but also highlighted the significance of glycated haemoglobin (HbA1c) in this context. Consequently, the findings advocate for the inclusion of GA and HbA1c monitoring in prenatal care practices as a means to enhance early detection and management strategies for GDM, aiming to mitigate the adverse outcomes associated with this condition.