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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2016
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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 |
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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 |
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