Pakistan Armed Forces Medical Journal (Aug 2020)
CYSTATIN C AS A SCREENING BIOMARKER OF GESTATIONAL DIABETES MELLITUS
Abstract
Objective: To evaluate cystatin C as a screening biomarker for early detection of gestational diabetes mellitus (GDM). Study Design: Case control study. Place and Duration of Study: Army Medical College and Pak Emirates Military Hospital, from Dec 2017 Jun 2018. Methodology: This case control study was conducted at department of Chemical Pathology, Army Medical College and Pak Emirates Military Hospital Rawalpindi. A total of 30 women with gestational diabetes (cases) and 30 healthy pregnant women (control) were recruited in the study. HbA1c, cystatin C and insulin levels were performed on samples of all the participants. Seventy-five gram OGGT was performed on all subjects. Paired t-test and Odds ratio were calculated for cases and controls. Results: The cystatin C levels were high with increasing parity. Paired sample t test showed strong association of cystatin C to HbA1c, fasting and post load glucose levels in patients of GDM (HbA1c t (60)=36.0, p0.95) of maternal plasma showed positive association with one-hour (OR=4.7) and two-hour (OR=4.3) post load plasma glucose levels in OGTT. Conclusion: This study strongly suggested that cystatin C may be used as preliminary screening biomarker for early detection of GDM. Patients having elevated levels of cystatin C then can be further evaluated using OGTT. This two-step approach has potential to rationalize the diagnostic work up of this category of patients and would also result in evidence-based patient management.