Unveiling Serum Uric Acid as an Early Biomarker for Gestational Diabetes Risk: A Prospective Observational Validation

Syed Farhat Unjum Reyaz; Cimona Lyn Saldanha; Aakash Uttam; Jaffar Ahmad Bhat; Pariksha Pariksha; Sayeeda Irtiza Reyaz

doi:10.37022/wjcmpr.v8i3.434

Authors

Syed Farhat Unjum Reyaz Postgraduate Scholar, Department of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Jammu and Kashmir, India (190011)
Cimona Lyn Saldanha Professor and Head, Department of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Jammu and Kashmir, India (190011)
Aakash Uttam Senior Resident, Department of Radiodiagnosis, AIIMS Vijaypur, Jammu
Jaffar Ahmad Bhat Postgraduate Scholar, Department of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Jammu and Kashmir, India (190011)
Pariksha Senior Resident, Department of Obstetrics and Gynaecology, GMC kathua
Sayeeda Irtiza Reyaz PhD Scholar, Department of Biochemistry, University of Delaware, USA

Abstract

Background: Serum uric acid, a marker linked to oxidative stress, endothelial dysfunction and insulin resistance, has been proposed as an inexpensive early biomarker of gestational diabetes mellitus (GDM), but the evidence remains heterogeneous.

Objective: To examine the association between serum uric acid measured at 0–18 weeks of gestation and the subsequent development of GDM, and to describe maternal and neonatal outcomes according to GDM status.

Methods: This prospective observational study was conducted over 18 months in the Department of Obstetrics and Gynaecology, SKIMS, Srinagar. Women with singleton pregnancies registered early for antenatal care and without pre-existing chronic disease were enrolled (N = 225). Serum uric acid was measured at the first antenatal visit. GDM was diagnosed at 24–28 weeks by a 75 g oral glucose tolerance test using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Groups were compared using the chi-square test and the unpaired t test, and the discriminative ability of uric acid was assessed by receiver operating characteristic (ROC) analysis.

Results: GDM developed in 56 women (24.9%). Mean serum uric acid was 5.54 ± 2.23 mg/dL in women who developed GDM and 3.60 ± 1.28 mg/dL in those who did not (p < 0.01). At a cut-off of 4.95 mg/dL, the reported sensitivity was 70.6% and specificity 83% (area under the curve 0.770; p < 0.001). Family history of diabetes (23.2% vs 1.2%) and of gestational hypertension (46.4% vs 10.1%) was more frequent in the GDM group (both p < 0.001). Women with GDM more often delivered by lower segment caesarean section (58.9% vs 16.0%; p < 0.001), had infants weighing more than 4 kg (30.4% vs 0%; p < 0.001) and had neonates admitted to intensive care (28.6% vs 5.9%; p = 0.002). No maternal or neonatal deaths occurred.

Conclusions: Higher serum uric acid at booking was associated with later GDM, with moderate reported discrimination. These unadjusted findings from a single centre support further evaluation of uric acid as a low-cost adjunct for early risk stratification, but do not justify its use as a stand-alone screening test.

Keywords:

Uric acid, Diabetes, Gestational, Biomarkers, ROC Curve, Pregnancy Outcome, Prospective Studies

DOI

https://doi.org/10.37022/wjcmpr.v8i3.434

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