Expression and clinical value of the plasma peroxiredoxin family in early pregnancy for predicting subsequent gestational diabetes mellitus

Abstract

BACKGROUND

Many biomarkers have been developed to facilitate early gestational diabetes mellitus (GDM) diagnosis, but they have multiple limitations, including low accuracy and constraints in detection methods. The majority of biomarkers are influenced by gestational age, sample sizes and types, and analytical methodologies. Thus, there is a need of more accurate biomarkers for early diagnosis.

AIM

To investigate the expression of the peroxiredoxin (PRDX) family in early pregnancy and its clinical value for predicting subsequent GDM.

METHODS

Plasma samples and clinical data were collected at < 12 weeks of gestation from 222 women who subsequently developed GDM (confirmed by the 75 g oral glucose tolerance test at 24-28 weeks) and 222 women who remained normoglycemic throughout pregnancy, using random sampling at our hospital between January 2019 and December 2025. Participants were assigned to the observation group and control group accordingly. Plasma PRDX (PRDX1-PRDX6) levels were measured by ELISA. Receiver operating characteristic curves were applied for the assessment of the diagnostic value of PRDXs for early GDM. Univariate and multivariate logistic regression analyses were performed to identify related independent risk factors.

RESULTS

Baseline characteristics [age, pre-pregnancy body mass index (BMI), mid-pregnancy BMI] and biochemical indicators (triglycerides, low-density lipoprotein-cholesterol, fasting blood glucose, glycated hemoglobin) were markedly higher in the GDM group (P < 0.05). Expression levels of all PRDX family members in plasma showed obvious elevations in the observation group (P < 0.05). PRDX1, PRDX4, and PRDX5 displayed high diagnostic value for early GDM, with areas under the curve of 0.757, 0.776, and 0.742, respectively, and a combined diagnostic area under the curve of 0.836. Univariate analysis identified 15 significant risk factors, and multivariate analysis revealed age, pre-pregnancy BMI, triglycerides, low-density lipoprotein-cholesterol, fasting blood glucose, glycated hemoglobin, PRDX1, and PRDX3 as independent risk factors for early GDM (P < 0.05).

CONCLUSION

All PRDX family members showed significantly elevated expression in early GDM. PRDX1, PRDX4, and PRDX5 exhibited substantial diagnostic value, while PRDX1 and PRDX3 were identified as independent risk factors.

Keywords: Peroxiredoxins; Early gestational diabetes mellitus; Expression; Diagnostic value; Independent risk factors

Core Tip: This study provides the first comprehensive assessment of the plasma peroxiredoxin (PRDX) family in early pregnancy as predictive biomarkers for gestational diabetes mellitus. PRDX1, PRDX4, and PRDX5 demonstrated strong individual diagnostic performance (areas under the curve: 0.757, 0.776, and 0.742, respectively), and their combination further improved accuracy to 0.836. Furthermore, PRDX1 and PRDX3 were identified as independent risk factors for early gestational diabetes mellitus, highlighting the potential of the PRDX family for early screening and risk stratification.