Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis

AIMS/HYPOTHESIS: Universal screening for gestational diabetes mellitus (GDM) has not been implemented, and this has had substantial clinical implications. Biomarker-directed targeted screening might be feasible. We sought to determine the accuracy of circulating adiponectin for early prediction of G...

Descripción completa

Detalles Bibliográficos
Autores principales: Iliodromiti, Stamatina, Sassarini, Jennifer, Kelsey, Thomas W., Lindsay, Robert S., Sattar, Naveed, Nelson, Scott M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779132/
https://www.ncbi.nlm.nih.gov/pubmed/26768001
http://dx.doi.org/10.1007/s00125-015-3855-6
_version_ 1782419584267059200
author Iliodromiti, Stamatina
Sassarini, Jennifer
Kelsey, Thomas W.
Lindsay, Robert S.
Sattar, Naveed
Nelson, Scott M.
author_facet Iliodromiti, Stamatina
Sassarini, Jennifer
Kelsey, Thomas W.
Lindsay, Robert S.
Sattar, Naveed
Nelson, Scott M.
author_sort Iliodromiti, Stamatina
collection PubMed
description AIMS/HYPOTHESIS: Universal screening for gestational diabetes mellitus (GDM) has not been implemented, and this has had substantial clinical implications. Biomarker-directed targeted screening might be feasible. We sought to determine the accuracy of circulating adiponectin for early prediction of GDM. METHODS: A systematic review and meta-analysis of the literature to May 2015 identified studies in which circulating adiponectin was measured prior to a diagnosis of GDM. Data on diagnostic accuracy were synthesised by bivariate mixed effects and hierarchical summary receiver operating characteristic (HSROC) models. RESULTS: Thirteen studies met the eligibility criteria, 11 of which (2,865 women; 794 diagnosed with GDM) had extractable data. Circulating adiponectin had a pooled diagnostic odds ratio (DOR) of 6.4 (95% CI 4.1, 9.9), a summary sensitivity of 64.7% (95% CI 51.0%, 76.4%) and a specificity of 77.8% (95% CI 66.4%, 86.1%) for predicting future GDM. The AUC of the HSROC was 0.78 (95% CI 0.74, 0.81). First trimester adiponectin had a pooled sensitivity of 60.3% (95% CI 46.0%, 73.1%), a specificity of 81.3% (95% CI 71.6%, 88.3%) and a DOR of 6.6 (95% CI 3.6, 12.1). The AUC was 0.79 (95% CI 0.75, 0.82). Pooled estimates were similar after adjustment for age, BMI or specific GDM diagnostic threshold. CONCLUSIONS/INTERPRETATION: Pre-pregnancy and early pregnancy measurement of circulating adiponectin may improve the detection of women at high risk of developing GDM. Prospective evaluation of the combination of adiponectin and maternal characteristics for early identification of those who do and do not require OGTT is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-015-3855-6) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
format Online
Article
Text
id pubmed-4779132
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-47791322016-03-19 Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis Iliodromiti, Stamatina Sassarini, Jennifer Kelsey, Thomas W. Lindsay, Robert S. Sattar, Naveed Nelson, Scott M. Diabetologia Meta-Analysis AIMS/HYPOTHESIS: Universal screening for gestational diabetes mellitus (GDM) has not been implemented, and this has had substantial clinical implications. Biomarker-directed targeted screening might be feasible. We sought to determine the accuracy of circulating adiponectin for early prediction of GDM. METHODS: A systematic review and meta-analysis of the literature to May 2015 identified studies in which circulating adiponectin was measured prior to a diagnosis of GDM. Data on diagnostic accuracy were synthesised by bivariate mixed effects and hierarchical summary receiver operating characteristic (HSROC) models. RESULTS: Thirteen studies met the eligibility criteria, 11 of which (2,865 women; 794 diagnosed with GDM) had extractable data. Circulating adiponectin had a pooled diagnostic odds ratio (DOR) of 6.4 (95% CI 4.1, 9.9), a summary sensitivity of 64.7% (95% CI 51.0%, 76.4%) and a specificity of 77.8% (95% CI 66.4%, 86.1%) for predicting future GDM. The AUC of the HSROC was 0.78 (95% CI 0.74, 0.81). First trimester adiponectin had a pooled sensitivity of 60.3% (95% CI 46.0%, 73.1%), a specificity of 81.3% (95% CI 71.6%, 88.3%) and a DOR of 6.6 (95% CI 3.6, 12.1). The AUC was 0.79 (95% CI 0.75, 0.82). Pooled estimates were similar after adjustment for age, BMI or specific GDM diagnostic threshold. CONCLUSIONS/INTERPRETATION: Pre-pregnancy and early pregnancy measurement of circulating adiponectin may improve the detection of women at high risk of developing GDM. Prospective evaluation of the combination of adiponectin and maternal characteristics for early identification of those who do and do not require OGTT is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-015-3855-6) contains peer-reviewed but unedited supplementary material, which is available to authorised users. Springer Berlin Heidelberg 2016-01-14 2016 /pmc/articles/PMC4779132/ /pubmed/26768001 http://dx.doi.org/10.1007/s00125-015-3855-6 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Meta-Analysis
Iliodromiti, Stamatina
Sassarini, Jennifer
Kelsey, Thomas W.
Lindsay, Robert S.
Sattar, Naveed
Nelson, Scott M.
Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title_full Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title_fullStr Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title_full_unstemmed Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title_short Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
title_sort accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779132/
https://www.ncbi.nlm.nih.gov/pubmed/26768001
http://dx.doi.org/10.1007/s00125-015-3855-6
work_keys_str_mv AT iliodromitistamatina accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis
AT sassarinijennifer accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis
AT kelseythomasw accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis
AT lindsayroberts accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis
AT sattarnaveed accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis
AT nelsonscottm accuracyofcirculatingadiponectinforpredictinggestationaldiabetesasystematicreviewandmetaanalysis