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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 54, Issue 3


Early prediction of gestational diabetes: a practical model combining clinical and biochemical markers

Sébastien Thériault
  • CHU de Québec Research Center, Quebec City, QC, Canada
  • Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Yves Giguère
  • CHU de Québec Research Center, Quebec City, QC, Canada
  • Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jacques Massé
  • CHU de Québec Research Center, Quebec City, QC, Canada
  • Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Joël Girouard
  • CHU de Québec Research Center, Quebec City, QC, Canada
  • Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jean-Claude Forest
  • Corresponding author
  • CHU de Québec Research Center, Quebec City, QC, Canada
  • Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-08-06 | DOI: https://doi.org/10.1515/cclm-2015-0537


Background: Gestational diabetes (GDM) is usually diagnosed late in pregnancy, precluding early preventive interventions. This study aims to develop a predictive model based on clinical factors and selected biochemical markers for the early risk assessment of GDM.

Methods: Based on a prospective cohort of 7929 pregnant women from the Quebec City metropolitan area, a nested case-control study was performed including 264 women who developed GDM. Each woman who developed GDM was matched with two women with normal glycemic profile. Risk prediction models for GDM and GDM requiring insulin therapy were developed using multivariable logistic regression analyses, based on clinical characteristics and the measurement of three clinically validated biomarkers: glycated hemoglobin (HbA1c), sex hormone binding globulin (SHBG) and high-sensitivity C-reactive protein (hsCRP) measured between 14 and 17 weeks of gestation.

Results: HbA1c and hsCRP were higher and SHBG was lower in women who developed GDM (p<0.001). The selected model for the prediction of GDM, based on HbA1c, SHBG, BMI, past history of GDM, family history of diabetes and soft drink intake before pregnancy yielded an area under the ROC curve (AUC) of 0.79 (0.75–0.83). For the prediction of GDM requiring insulin therapy, the selected model including the same six variables yielded an AUC of 0.88 (0.84–0.92) and a sensitivity of 68.9% at a false-positive rate of 10%.

Conclusions: A simple model based on clinical characteristics and biomarkers available early in pregnancy could allow the identification of women at risk of developing GDM, especially GDM requiring insulin therapy.

Keywords: biomarkers; early pregnancy; gestational diabetes; model


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About the article

Corresponding author: Jean-Claude Forest, MD, PhD, FRCPC, CHU de Québec Research Center, 10, rue de l’Espinay, Quebec City, QC G1L 3L5, Canada, Phone: +1 418 525 4444 ext. 54438, Fax: +1 418 525 4195, E-mail: ; and Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada

Received: 2015-06-09

Accepted: 2015-07-09

Published Online: 2015-08-06

Published in Print: 2016-03-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 3, Pages 509–518, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0537.

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