Emerging biomarkers for gestational diabetes mellitus and related pediatric outcomes

Table 10 Summarized details of emerging protein biomarkers for diagnosis and early prediction of gestational diabetes mellitus and associated outcomes

Biomarker	Protein function	Association with GDM	Potential role	Clinical utility	Advantages	Ref.
Fetuin-A	Insulin resistance	Elevated levels of fetuin-A have been associated with GDM	Fetuin-A may play a role in insulin resistance and glucose metabolism during pregnancy	Fetuin-A may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	Fetuin-A is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Bogdanet et al[6], Ruszała et al[7], Wu et al[170], Cai et al[171]
IGFBP-1	Glucose metabolism	Decreased levels of IGFBP-1 have been associated with GDM	IGFBP-1 may play a role in glucose metabolism and insulin sensitivity during pregnancy	IGFBP-1 may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	IGFBP-1 is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Alekseenkova et al[59], Hivert et al[172], Hong et al[173], Martín-Estal et al[174]
SHBG	Sex hormone transport	Low levels of SHBG have been associated with GDM	Associated with insulin resistance and GDM	SHBG may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	SHBG is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Bruno et al[175], Sharmin et al[176], Liu et al[177]
RBP4	Retinol transport	Elevated levels of RBP4 have been associated with GDM	RBP4 may play a role in insulin resistance and glucose metabolism during pregnancy	RBP4 may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	RBP4 is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Kučerová et al[178], Leca et al[179], Mousavi et al[180]
Afamin	Vitamin E transport	Elevated levels of Afamin have been associated with GDM	Afamin may play a role in glucose metabolism and insulin sensitivity during pregnancy	Afamin may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	Afamin is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Eroğlu et al[181], Atakul et al[182], Wang et al[183]
Fibronectin	Cell adhesion and migration	Altered levels of fibronectin have been associated with GDM	Fibronectin may play a role in placental development and function, and its dysregulation may contribute to GDM	Fibronectin may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	Fibronectin is a relatively stable protein that can be measured in maternal serum or plasma, making it a potentially useful biomarker for GDM	Ruszała et al[7], Karoutsos et al[184]
Betatrophin	Glucose and lipid metabolism	Altered levels of Betatropin have been associated with GDM	Betatropin may play a role in regulating glucose metabolism and insulin sensitivity during pregnancy	Betatropin may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	Betatropin is a relatively novel biomarker that may provide new insights into GDM pathophysiology	Xu et al[185], Guo et al[186], Kirlangic et al[187], Melekoglu and Celik[188]
PAPP-A	Regulating placental function and fetal growth	Altered levels of PAPP-A have been associated with GDM	PAPP-A may play a role in regulating insulin-like growth factor bioavailability and glucose metabolism during pregnancy	PAPP-A may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	PAPP-A is a well-established biomarker for placental function and may provide insights into GDM pathophysiology	Conover and Oxvig[189], Yanachkova et al[190]
SFlt-1	Regulating angiogenesis and vascular function	Altered levels of sFlt-1 have been associated with GDM	SFlt-1 may play a role in regulating angiogenesis and vascular function in GDM	SFlt-1 may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	SFlt-1 is a well-established biomarker for preeclampsia and may provide insights into GDM pathophysiology	Joshi et al[191], Liao et al[192], Gul Kara et al[193]
PlGF	Promoting angiogenesis, regulating placental development and enhancing vascular function	Altered levels of PlGF have been associated with GDM	PlGF may play a role in regulating angiogenesis and placental function in GDM	PlGF may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	PlGF is a well-established biomarker for placental function and may provide insights into GDM pathophysiology	Yanachkova et al[190], Bolatai et al[194]
Apo	Lipid metabolism	Altered levels of Apo (e.g., ApoA1, ApoB) have been associated with GDM	Apo may play a role in regulating lipid metabolism and insulin sensitivity in GDM	Apo may be used to identify women at high risk of developing GDM, allowing for early intervention and prevention strategies	Apo are well-established biomarkers for cardiovascular disease and may provide insights into GDM pathophysiology	Balachandiran et al[145], Bernea et al[169]

Apo: Apolipoproteins; GDM: Gestational diabetes mellitus; IGFBP-1: Insulin-like growth factor binding protein-1; PAPP-A: Pregnancy-associted plasma protein-A; PlGF: Placental growth factor; RBP4: Retinol-binding protein 4; SFlt-1: Soluble fms-like tyrosine kinase-1; SHBG: Sex hormone-binding globulin.