Soluble (Pro) Renin Receptor is a Predictor of Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus (GDM) is a common endocrine complication in pregnancy. While it has been established that age, family history of diabetes, insulin resistance and several biomarkers are associated with GDM but significant gaps remain in understanding risk factors for GDM. Soluble pro-renin receptor (s [Pro] RR) as a biomarker reflects the activation of renin-angiotensin system in tissues which may be related to insulin resistance Objective: The aim of this study was to determine the role of (s [pro] RR) in predicting GDM. Methods: one hundred-eighty singleton pregnant women in first trimester were enrolled. We excluded women with previous history of GDM, hypertension and consumption of drugs affected reninangiotensin system. A fasting blood glucose and s (pro) RR level were obtained during first trimester and OGTT was performed at 24-28 weeks of gestation. We used ROC curves to identify s (pro) RR cutoff points for detecting GDM and the difference in s (pro)RR level was assessed in GDM and non- GDM women. Results: Among 180 women, 24 (13.33%) had GDM. There was no significant difference between age and body mass index in subjects with GDM compared to non- GDM. The concentration of s (pro) RR was significantly higher in GDM subjects rather than non- GDM [29.27(24.60-35.92) vs. 22.89(19.46- 24.27), P<0.001]. Multiple logistic regression analysis revealed a significant association of s(pro) RR with GDM (odd ratio: 1.32, 95% CI: 1.17-1.48, P=0.04). A cut-off point 24.52 ng/ml of s(pro) RR had 75% sensitivity and 80% specificity for predicting GDM. Conclusion: Increased level of s (pro) RR in first trimester may be a marker for predicting GDM.