A Prospective Study on the Accuracy of Glycated Albumin in Diagnosing Pregnancies Complicated with Gestational Diabetes Mellitus

Authors

  • Hira Saleem
  • Ghazala Iftikhar
  • Rabia Nazeer
  • Huma Fiaz
  • Nergis Taj
  • Sumera Brohi
  • Ramsha Depar
  • Huma Ahmad

DOI:

https://doi.org/10.63682/jns.v13i1.8420

Keywords:

Gestational diabetes mellitus, Glycated albumin, OGTT, Pregnancy, Diagnostic accuracy, ROC curve

Abstract

Background: Gestational diabetes mellitus (GDM) remains to be among the commonest challenge faced during pregnancy and it is of great risk to maternal and the fetus. ‘Although GDM is generally diagnosed using an oral glucose tolerance test (OGTT) not without some drawbacks including inconvenience and low reproducibility there is a growing diabetes gap’. The necessity for alternative biomarkers is evident. Emerging evidence suggests that glycated albumin (GA), which monitors short-term diabetes management, may be helpful in predicting GDM much earlier. This study seeks to evaluate the diagnostic accuracy of GA in comparison with the OGTT and assess its performance against primary GDM screening.

Methods: This study recruited 81 pregnant women who were between 20 to 28 weeks of gestation. The participants performed ‘standard glucose tolerance tests for the diagnosis of gestational diabetes along with simultaneous testing for albumin glycation’. GA’s diagnostic performance was assessed by calculating sensitivity, specificity, and area under the ROC curve (AUC).

Results: GA levels were significantly higher in the GDM group compared to non-GDM participants (15.3% vs. 12.1%, p < 0.001). GA demonstrated high diagnostic accuracy with a sensitivity of 85.7%, specificity of 84.6%, and an AUC of 0.89. Elevated GA values were also associated with higher neonatal birth weights and increased rates of cesarean delivery.

Conclusion: Glycated albumin has substantial promise as an alternative or adjunct diagnostic marker for GDM. Its use is particularly beneficial in clinics where OGTT is impractical due to high precision, shorter timeframes of detection, and ease of testing.

Downloads

Download data is not yet available.

References

Chume, F.C., et al., Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus? Endocrine, 2021. 72: p. 681-687.

Xiong, J.-Y., et al., Glycated albumin as a biomarker for diagnosis of diabetes mellitus: A systematic review and meta-analysis. World Journal of Clinical Cases, 2021. 9(31): p. 9520.

Dong, Y., et al., Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes. BMC Pregnancy and Childbirth, 2020. 20: p. 1-9.

Liu, X., N. Wu, and A. Al-Mureish, A review on research progress in the application of glycosylated hemoglobin and glycated albumin in the screening and monitoring of gestational diabetes. International Journal of General Medicine, 2021: p. 1155-1165.

Toft, J.H., et al., Glycated albumin in pregnancy: LC-MS/MS-based reference interval in healthy, nulliparous Scandinavian women and its diagnostic accuracy in gestational diabetes mellitus. Scandinavian Journal of Clinical and Laboratory Investigation, 2022. 82(2): p. 123-131.

Sugawara, D., et al., Clinical usefulness of glycated albumin and glycated albumin-to-glycated hemoglobin ratio of gestational diabetes mellitus in late pregnancy for predicting infant complications. Pediatrics & Neonatology, 2022. 63(3): p. 239-246.

Piuri, G., et al., Methylglyoxal, glycated albumin, PAF, and TNF-α: possible inflammatory and metabolic biomarkers for management of gestational diabetes. Nutrients, 2020. 12(2): p. 479.

Zamre, N., et al., Glycated Albumin as a Novel Biomarker for Diabetes in Pregnancy: Current Status and Future Prospect. early pregnancy. 6: p. 8.

Rescalli, A., et al., Analytical challenges in diabetes management: towards glycated albumin point-of-care detection. Biosensors, 2022. 12(9): p. 687.

Toft, J.H., et al., Glycated albumin and continuous glucose monitoring metrics across pregnancy in women with pre‐gestational diabetes. Endocrinology, Diabetes & Metabolism, 2022. 5(6): p. e376.

Sharafeldeen, A., A.F. Al-Kholy, and N. Elhamamy, Estimated Glycated albumin'levels early in pregnancy could detect women at risk to develop gestational diabetes mellitus. SVU-International Journal of Medical Sciences, 2023. 6(2): p. 787-798.

Pang, W.W., et al., A longitudinal study of plasma glycated albumin across pregnancy and associations with maternal characteristics and cardiometabolic biomarkers. Clinical chemistry, 2023. 69(12): p. 1420-1428.

Giglio, R.V., et al., Recent updates and advances in the use of glycated albumin for the diagnosis and monitoring of diabetes and renal, cerebro-and cardio-metabolic diseases. Journal of Clinical Medicine, 2020. 9(11): p. 3634.

Kohzuma, T., X. Tao, and M. Koga, Glycated albumin as biomarker: Evidence and its outcomes. Journal of Diabetes and its Complications, 2021. 35(11): p. 108040.

Paleari, R., et al., Reference intervals for glycated albumin during physiological pregnancy of Europid women: evidences from a prospective observational study. Clinica Chimica Acta, 2023. 541: p. 117246.

Azzam, M.N., et al., Association between Glycemic Control and Birth Weight with Glycated Albumin in Women with Gestational Diabetes Mellitus. The Egyptian Journal of Hospital Medicine, 2020. 81(3): p. 1552-1557.

Kansu-Celik, H., et al., Maternal serum glycosylated hemoglobin and fasting plasma glucose predicts gestational diabetes at the first trimester in Turkish women with a low-risk pregnancy and its relationship with fetal birth weight; a retrospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, 2021. 34(12): p. 1970-1977.

Suo, M., et al., Comparative study on hemoglobin A1c, glycated albumin and glycosylated serum protein in aplastic anemia patients with Type 2 diabetes mellitus. Bioscience Reports, 2020. 40(5): p. BSR20192300.

Meek, C.L., et al., Novel biochemical markers of glycemia to predict pregnancy outcomes in women with type 1 diabetes. Diabetes Care, 2021. 44(3): p. 681-689.

Shaarbaf Eidgahi, E., et al., Diagnostic accuracy of first and early second trimester multiple biomarkers for prediction of gestational diabetes mellitus: a multivariate longitudinal approach. BMC pregnancy and childbirth, 2022. 22(1): p. 13.

Downloads

Published

2025-07-19

How to Cite

1.
Saleem H, Iftikhar G, Nazeer R, Fiaz H, Taj N, Brohi S, Depar R, Ahmad H. A Prospective Study on the Accuracy of Glycated Albumin in Diagnosing Pregnancies Complicated with Gestational Diabetes Mellitus. J Neonatal Surg [Internet]. 2025Jul.19 [cited 2025Oct.10];13(1):445-50. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/8420

Issue

Section

Original Article

Most read articles by the same author(s)