First-trimester serum SHBG and vaspin as combined biomarkers for predicting gestational diabetes mellitus: a case–control accuracy study

OBJECTIVES: Early prediction of gestational diabetes mellitus (GDM) is crucial. This study evaluated the combined predictive value of sex hormone-binding globulin (SHBG) and visceral adipose tissue-derived serine protease inhibitor (vaspin) in early pregnancy for GDM. METHODS: weeks of gestation. Serum levels of SHBG and vaspin were measured by enzyme-linked immunosorbent assay (ELISA). Clinical data including age, body mass index (BMI), parity, family history of diabetes, gestational age, amniotic fluid index (AFI), mode of delivery, and neonatal birth weight were compared between groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the predictive value of individual and combined biomarkers. RESULTS: Pre-pregnancy BMI, cesarean section rate, and neonatal birth weight were significantly higher in the GDM group. Serum SHBG levels were significantly lower (392.26 ± 46.34 vs. 454.49 ± 31.66 nmol/mL, p<0.001), and vaspin levels were significantly higher (3.04 ± 0.47 vs. 2.54 ± 0.36 ng/mL, p<0.001) in GDM. The combined model of SHBG and vaspin showed superior predictive performance (AUC=0.934, accuracy=91.0 %, sensitivity=87.2 %, specificity=94.9 %) compared to either biomarker alone. CONCLUSIONS: The combined measurement of serum SHBG and vaspin in early pregnancy suggests a potentially useful predictive performance for GDM. While limited by the relatively small sample size and the research-use-only nature of the vaspin assay, this dual-biomarker approach warrants further validation in larger studies before its clinical applicability can be fully established.