High level of complement factor Ba within first prenatal test of gestation increases the risk of subsequent gestational diabetes: a propensity score-matched study

Abstract

Objective

This study was to assess the alteration of circulating complement factor Ba (CFBa) within 11 to 17 weeks of gestation and its association with subsequent gestational diabetes mellitus (GDM) and its delivery outcome.

Methods

Biochemical parameters and blood samples were collected from 399 pregnant women within 11 to 17 weeks of gestation. At 24 to 28 weeks of gestation, all participants underwent 75-g oral glucose tolerance test and were assigned to GDM group (n = 80) and normal control group (n = 319). Perinatal data were collected after delivery. A propensity score-matched (PSM) analysis was performed to reduce the impact of confounding factors on glucose metabolism during pregnancy between the two groups.

Results

Two groups of 74 well-matched patients who maintained balance in terms of baseline characteristics. The levels of CFBa in pregnant women who later developed GDM were significantly higher than those in healthy pregnant women [0.4(0.1–0.8) vs. 0.2(0.2–0.3), p = 0.024]. Logistic regression analysis results confirmed that the level of CFBa was an independent impact factor for the occurrence of GDM (OR = 1.57, 95% CI: 1.118–2.210, p = 0.009). Further grouping according to the median level of CFBa, it was found that the incidence of GDM in category two (>0.23 ng/ml, n = 74) was markedly higher than that in the first category (≤0.23 ng/ml, n = 74) (p = 0.021).

Conclusions

High level of the CFBa within 11 to 17 weeks of gestation increases the risk of subsequent GDM, and maybe a biomarker for predicting GDM.

首次产前筛查的补体因子Ba升高预示妊娠期糖尿病风险增加：一项倾向性评分匹配研究 摘要

目的：本研究旨在评估妊娠11-17周补体因子Ba（CFBa）在母血循环中的变化及其与妊娠期糖尿病（GDM）、分娩结局的关系。 方法：收集399名妊娠11-17周孕妇的生化指标和血液样本。受试者妊娠24-28周时行75g口服糖耐量试验, 并分为GDM组（n=80）和正常对照组（n=319）。分娩后收集围产期资料。采用倾向性评分匹配（PSM）进行分析, 以减少两组间孕期糖代谢的混杂因素的影响。 结果：两组74名匹配良好的患者在基线特征方面保持平衡。GDM孕妇的CFBa水平明显高于健康孕妇 [0.4（0.1-0.8）vs. 0.2（0.2-0.3）, p=0.024]。Logistic回归的分析结果证实CFBa水平是发生GDM的独立影响因素（OR=1.57, 95% CI：1.118-2.210, p=0.009）。进一步按CFBa中位数水平分组发现, 第二类患者（>0.23ng/ml, n=74）的GDM发生率明显高于第一类患者（≤0.23ng/ml, n=74）（p=0.021）。 结论：妊娠11-17周高水平CFBa孕妇发生GDM的风险也增加, 这可能是一个预测GDM的标志物。

Keywords:

• Complement factor Ba
• first prenatal test of gestation
• gestational diabetes mellitus
• perinatal outcome
• propensity score-matched

Acknowledgments

The authors sincerely thank all the participants and the field workers for their support and help in this study.

Data availability statement

The data sets of this study are available from the corresponding authors upon reasonable request.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under Grant number 81770802.