Prediction of gestational diabetes in obese pregnant women from the UK Pregnancies Better Eating and Activity (UPBEAT) pilot trial

Diabet Med. 2014 Aug;31(8):963-70. doi: 10.1111/dme.12482. Epub 2014 May 24.


Aim: To examine the prediction of gestational diabetes in obese women using routine clinical measures and measurement of biomarkers related to insulin resistance in the early second trimester.

Methods: A total of 117 obese pregnant women participating in a pilot trial of a complex intervention of dietary advice and physical activity were studied. Blood samples were obtained at recruitment (15⁺⁰-17⁺⁶ weeks' gestation) and demographic, clinical history and anthropometric measures recorded. The biomarkers analysed were plasma lipids (HDL cholesterol, LDL cholesterol, triglycerides), high-sensitivity C-reactive protein, alanine transaminase, aspartate transaminase, ferritin, fructosamine, insulin, adiponectin, tissue plasminogen activator, interleukin-6, visfatin and leptin. Univariate and logistic regression analyses were performed to determine independent predictors and area under the receiver-operating curve was calculated for the model.

Results: Of the 106 participants included in the analysis, 29 (27.4%) developed gestational diabetes. Participants with gestational diabetes were older (P = 0.002), more often of parity ≥ 2, had higher systolic (P = 0.02) and diastolic blood pressure (P = 0.02) and were more likely to be black (P = 0.009). Amongst the blood biomarkers measured, plasma adiponectin alone remained independently associated with gestational diabetes in adjusted models (P = 0.002). The area under the receiver-operating curve for clinical factors alone (0.760) increased significantly (area under the curve 0.834, chi-square statistic (1) = 4.00, P = 0.046) with the addition of adiponectin.

Conclusions: A combination of routinely measured clinical factors and adiponectin measured in the early second trimester in obese women may provide a useful approach to the prediction of gestational diabetes. Validation in a large prospective study is required to determine the usefulness of this algorithm in clinical practice.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Adolescent
  • Adult
  • Biomarkers / blood
  • Body Mass Index
  • Combined Modality Therapy
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / etiology
  • Diabetes, Gestational / prevention & control*
  • Diet, Reducing*
  • Female
  • Humans
  • Motor Activity*
  • Obesity / blood
  • Obesity / diet therapy
  • Obesity / physiopathology
  • Obesity / therapy*
  • Pilot Projects
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / diet therapy
  • Pregnancy Complications / physiopathology
  • Pregnancy Complications / therapy*
  • Pregnancy Trimester, Second
  • Prenatal Nutritional Physiological Phenomena*
  • Sensitivity and Specificity
  • Up-Regulation
  • Young Adult


  • ADIPOQ protein, human
  • Adiponectin
  • Biomarkers

Associated data

  • ISRCTN/ISRCTN89971375