Temporal Variation in Soluble Human Leukocyte Antigen-G (sHLA-G) and Pregnancy-Associated Plasma Protein A (PAPP-A) in Pregnancies Complicated by Gestational Diabetes Mellitus and in Controls

Problem To target gestational diabetes mellitus (GDM) by means of temporal variation in pregnancy-associated plasma protein A (PAPP-A) and soluble human leukocyte antigen-G (sHLA-G). Method of studyRetrospective analysis of PAPP-A and sHLA-G blood levels in historical samples of 112 GDM and 112 controls, drawn at first trimester, and prospective study in 18 GDM and 105 controls collected in triplicate along the pregnancy. Six hundred and sixty-five samples were analyzed. ResultsGestational diabetes mellitus had significantly lower first-trimester PAPP-A concentrations than controls (23431519 versus 2996 +/- 1955 mU/mL, in retrospective brunch and 2490.57 +/- 1828.52 versus 3240.84 +/- 1930.69mU/L in prospective one, P<0.001). First-trimester sHLA-G level was significantly lower in GDM than in controls (52.88 +/- 59.69 versus 66.81 +/- 50.14ng/mL, P<0.001) and increased during gestation in diabetic women showing an opposite trend with respect to the controls. ConclusionPAPP-A and sHLA-G are independent markers of GDM. Quantitative variations during pregnancy help to early unravel the onset of GDM.