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Relationship between serum uric acid in early pregnancy and gestational diabetes mellitus: a prospective cohort study

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Abstract

Purpose

The association between serum uric acid (UA) and gestational diabetes mellitus (GDM) was still unclear. Serum UA levels in pregnancy differed from that in non-pregnancy. This study aimed to investigate the changes of serum UA in early pregnancy, and to explore the association of serum UA with the risk of GDM.

Methods

A prospective double-center study including 873 singleton pregnant women was conducted in Beijing, China since 2019 (clinical trial number: NCT03246295). Seventy-eight healthy non-pregnant women were selected to compare the changes of biomarkers in pregnancy. Spearman correlation and logistic regression analysis were performed to measure the relationship between serum UA in early pregnancy and GDM.

Results

The incidence of GDM in our cohort was 20.27%(177/873). Compared with non-pregnant women, serum UA and creatinine decreased significantly during early pregnancy. Serum UA concentration in early pregnancy was significantly higher in GDM women than that in normal glucose tolerance (NGT) women [217.0(192.9, 272.0) μmol/l vs. 201.9(176.0, 232.0) μmol/l, p < 0.001]. After adjusted for confounding factors, elevated serum UA remained as an independent risk factor for GDM. The risk of GDM increased when serum UA was above 240 μmol/l (adjusted OR 1.964, 95% CI 1.296–2.977, p < 0.001), and stronger relationships between serum UA and GDM were observed in pregnant women aged over 35 years old and preBMI ≥ 24 kg/m2.

Conclusion

The normal range of serum UA and creatinine in pregnant women were lower than those in non-pregnant women. It is essential to monitor serum UA concentrations since early pregnancy to alert and prevent GDM, especially in older and heavier pregnant women.

Clinical trial number

NCT03246295.

Highlights

  • The levels of serum uric acid (UA) and creatinine in the first trimester of pregnant women were significantly lower than healthy non-pregnant women, probably because of the increase of glomerular filtration.

  • Serum UA concentration in the first trimester was significantly higher in women with gestational diabetes mellitus (GDM) than in women with normal glucose tolerance (NGT). The association of serum UA in the first trimester and GDM were observed when serum UA was above 240 μmol/l, and the association was stronger in women aged over 35 years old and preBMI ≥ 24 kg/m2.

  • To prevent GDM, healthy lifestyle intervention should be taken since early pregnancy to control serum UA concentration, especially in older and heavier pregnant women.

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Acknowledgements

The authors thank all the participants in this study.

Funding

This study was supported by 13th Five-Year National Science and Technology Major Project for New Drugs (Grant No. 2019ZX09734001 to W.Z.).

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Author notes

  1. These authors contributed equally: Tao Yuan, Weigang Zhao

Authors and Affiliations

  1. Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China

    Yanbei Duo, Shuoning Song, Yong Fu, Yingyue Dong, Tao Yuan & Weigang Zhao

  2. Department of Obstetrics, Haidian District Maternal and Child Health Care Hospital, Beijing, People’s Republic of China

    Yuemei Zhang

  3. Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People’s Republic of China

    Xiaolin Qiao, Yan Chen & Xiaorui Nie

  4. Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China

    Jiyu Xu & Wei Sun

  5. Department of Laboratory, Haidian District Maternal and Child Health Care Hospital, Beijing, People’s Republic of China

    Jing Zhang

  6. Department of Dean’s Office, Haidian District Maternal and Child Health Care Hospital, Beijing, People’s Republic of China

    Zhenyao Peng

  7. Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People’s Republic of China

    Qiujin Sun & Xianchun Yang

  8. National Center for Women and Children’s Health, China CDC, Beijing, People’s Republic of China

    Ailing Wang & Zechun Lu

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  1. Yanbei Duo
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Contributions

Yanbei Duo, T.Y., W.Z., W.S. and A.W. conceptualized the study; Y.Z., S.S., J.X., Y.C., X.N., Q.S., X.Y. and Z.L. performed the investigation; Yanbei Duo, X.Q., Z.P., J.Z., T.Y., Y.F. and Yingyue Dong determined the methodology; clinical data were collected by Yanbei Duo, S.S., Y.Z., X.Q., J.X. and Y.C.; the original draft was written by Yanbei Duo; the manuscript was edited by Yanbei Duo, T.Y., W.Z., W.S. and A.W.; T.Y. and W.Z. supervised the study. All authors approved the final draft of the manuscript.

Corresponding authors

Correspondence to Tao Yuan or Weigang Zhao.

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The authors declare no competing interests.

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Written informed consent was obtained from all participants.

Ethical approval

The study was performed in accordance with the Declaration of Helsinki as revised in 2013. This study was part of an ongoing prospective double-center observational cohort study started in 2019, which was conducted at Haidian District Maternal and Child Health Care Hospital and Chaoyang District Maternal and Child Health Care Hospital (Beijing, China) (clinical trial number: NCT03246295).

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Duo, Y., Song, S., Zhang, Y. et al. Relationship between serum uric acid in early pregnancy and gestational diabetes mellitus: a prospective cohort study. Endocrine 83, 636–647 (2024). https://doi.org/10.1007/s12020-023-03544-y

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