Assessment of Glycosylated Fibronectin Level in Maternal Serum as a Predictor of Gestational Diabetes Mellitus

Open Access

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with substantial maternal and neonatal risks, yet conventional screening at 24–28 weeks identifies hyperglycemia only after metabolic alterations are established. Early biomarkers may improve detection and intervention. Glycosylated fibronectin, a glycoprotein involved in cellular adhesion and endothelial function, has been suggested as a potential early predictor. Objective: This study aimed to assess maternal serum glycosylated fibronectin levels measured at 10–15 weeks of gestation as a predictor of subsequent GDM. Methods & Materials: A prospective cohort study was conducted at Dhaka Medical College Hospital from December 2020 to November 2021. Ninety-five pregnant women met the inclusion criteria after initial recruitment of 100 participants. Sociodemographic and clinical data were collected and serum glycosylated fibronectin levels were measured using ELISA. Participants underwent OGTT at booking, 24–28 weeks, with repeat testing at 34–36 weeks when required. Statistical analyses included ROC curve estimation and calculation of sensitivity, specificity, predictive values and relative risk. Results: GDM developed in 12.6% of participants. Mean glycosylated fibronectin was significantly higher in GDM compared with non-GDM women (226.7 ± 73.3 vs 114.2 ± 57.9 μg/ml). ROC analysis yielded an AUC of 0.895 (95% CI: 0.822–0.967). A cut-off value ≥145 μg/ml provided 83.3% sensitivity, 89.2% specificity and an accuracy of 88.4%. Women with elevated levels had a 20-fold increased risk of developing GDM. Conclusion: Elevated glycosylated fibronectin in early pregnancy is a strong predictor of GDM and may serve as a valuable biomarker for early screening.