The use of novel biomarkers for gestational diabetes mellitus diagnosis: A targeted omics study in African women

Objectives: This study aimed to evaluate whether IL-6, TNF-α, free fatty acids (FFAs), branched-chain amino acids (BCAAs), and acylcarnitines (C2, C4, C5, and C8) were associated with glycaemia in early and late stages of pregnancy Design: Multicentre Cross-sectional study Population: African women divided into two cohorts: early pregnancy (≤20 weeks) and late pregnancy (24-32 weeks). Methods: Potential biomarkers selected from the literature were analysed in both groups. Biomarker levels were compared between women with and without GDM in late pregnancy, and their discriminatory power was assessed by receiver-operator characteristic (ROC) curve analysis and their correlation with glycaemia levels was measured in both cohorts. Main outcome measures: Gestational diabetes mellitus (GDM) Results: A total of 477 and 170 women in late and early pregnancy, respectively, were included in the analysis. Among the 477 women, 78 (16.4%) had GDM. Women with GDM showed significantly higher levels of FFAs, and isoleucine, alongside lower levels of C2, C4, and C5 acylcarnitines, when compared to the non-GDM group (all p-values < 0.05), but ROC curves demonstrated sensitivities from 7.7% to 44.9% and specificities from 79.3% to 87.7% for GDM diagnosis. In early pregnancy, only valine correlated with blood glucose, independent of BMI and age (p=0.029). Conclusion: The selected biomarkers are not suitable for the diagnosis of GDM in a black African Population. Furthermore, they are not related to glycaemia in early pregnancy (except for valine) but are in late pregnancy, where they demonstrate altered FFA and BCAA metabolism in those with GDM.