Identification of proteomic biomarkers in maternal plasma in the early second trimester that predict the subsequent development of gestational diabetes.

INTRODUCTION: This study is designed to identify proteomic biomarkers that predict the subsequent development of gestational diabetes mellitus (GDM). METHODS: Maternal blood was obtained prospectively from healthy pregnant women in the early second trimester (16-20 weeks). Twelve women subsequently diagnosed with GDM at 24 to 28 weeks were selected as cases; an equal number of normoglycemic women as controls. Proteomic analysis of the previously stored plasma was performed by surface-enhanced laser desorption/ionization time-of-flight (SELDI-TOF) mass spectrometry. RESULTS: Three peaks (9122 Da, 9412 Da, and 9701 Da) that were increased in cases were characterized as isoforms of apolipoprotein CIII. Another discriminatory peak (17 105 Da) that was decreased in cases was matched to apolipoprotein AII. Enzyme-linked immunosorbent assay (ELISA) confirmed that women who subsequently developed GDM had significantly higher levels of apolipoprotein CIII than controls did. Levels of apolipoprotein AII failed to reach statistical significance. CONCLUSION: Our data suggest that there already exist biomarkers in the maternal circulation at 16 to 20 weeks in women who subsequently develop GDM.