First-trimester plasma asprosin and its association with gestational diabetes mellitus: A prospective cohort study

Background Asprosin a glucogenic adipokine associated with insulin resistance, has been found to be elevated in the plasma of women with gestational diabetes mellitus (GDM). Emerging evidence indicates that it can serve as a promising biomarker for the diagnosis of GDM during the second trimester. However, its utility in the first trimester has not yet been investigated. Therefore, the present study aimed to establish first-trimester reference ranges for plasma asprosin and to evaluate its predictive performance for the subsequent development of GDM. Methods In this prospective cohort study, low-risk women with singleton pregnancies at 10–14 weeks of gestation were consecutively enrolled. Participants with pregestational diabetes were excluded. Baseline clinical characteristics were documented, and blood samples were obtained for the measurement of plasma asprosin concentrations. The diagnosis of GDM at 24–28 weeks of gestation was established using the two-step screening approach. Results Among the 302 participants, 98 (32.5%) developed GDM. Asprosin concentrations did not differ significantly across gestational ages between 10 and 14 weeks. However, asprosin levels increased significantly with maternal BMI (p < 0.001), demonstrating a quadratic relationship. A first-trimester reference range for plasma asprosin was established. Nevertheless, first-trimester asprosin showed poor predictive performance for subsequent GDM (AUC = 0.516), whereas maternal BMI and age showed modest predictive ability. Conclusion First, a reference range for first-trimester asprosin was established, which may serve as a valuable benchmark for future investigations examining various aspects of diabetes in pregnancy. Second, first-trimester asprosin concentrations did not discriminate between women who subsequently developed GDM and those who did not.