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First-trimester C-reactive protein and subsequent gestational diabetes
Myles Wolf1, Laura Sandler, Karen Hsu
1Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. mswolf@partners.org
Diabetes Care
|March 1, 2003
Summary
Increased inflammation in early pregnancy, indicated by C-reactive protein (CRP) levels, is linked to gestational diabetes mellitus (GDM). This association is partly explained by higher body mass index (BMI).
Area of Science:
- Reproductive Endocrinology
- Metabolic Disorders
- Inflammation and Immunology
Background:
- Systemic inflammation is a known risk factor for type 2 diabetes.
- Gestational diabetes mellitus (GDM) is a precursor to type 2 diabetes.
- Early pregnancy inflammation may predict GDM development.
Purpose of the Study:
- To test if elevated first-trimester inflammation predicts subsequent GDM development.
- To investigate the association between C-reactive protein (CRP) and GDM risk.
Main Methods:
- Prospective nested case-control study within a pregnancy cohort.
- Measured first-trimester C-reactive protein (CRP) in 43 GDM cases and 94 controls.
- Used logistic regression to analyze CRP tertiles and GDM odds ratios, adjusting for covariates.
Main Results:
- Significantly higher first-trimester CRP levels in women who developed GDM (3.1 vs. 2.1 mg/l).
- Highest CRP tertile associated with 3.2-fold increased GDM risk (unadjusted).
- Adjusted GDM risk for highest CRP tertile was 3.6; attenuated to 1.5 when BMI was included.
Conclusions:
- First-trimester inflammation is associated with GDM development.
- Increased body mass index (BMI) partially mediates this association.
- Further research in larger cohorts is warranted to confirm findings.