Association of maternal serum uric acid levels with gestational diabetes mellitus: a hospital-based case-control study

Background: Gestational diabetes mellitus is a common metabolic complication of pregnancy. Serum uric acid has been investigated as an inexpensive biomarker linked to insulin resistance and metabolic dysfunction. This study examined the relationship between maternal serum uric acid and its association with glycaemic control. Methods: This case-control study enrolled 120 pregnant women between 24 and 40 weeks of gestation- 60 with GDM and 60 normoglycaemic controls. Demographic and clinical data were recorded, and serum uric acid was measured using an enzymatic uricase-peroxidase method. We assessed its association with GDM, random blood sugar (RBS), glycated hemoglobin (HbA1c) and treatment modality were evaluated and receiver operating characteristic (ROC) analysis were performed. Results: Women with GDM were older and more often overweight or obese than controls. Serum uric acid was significantly higher in the GDM group: 50.0% of cases had levels above 5.7 mg/dl, compared with 18.33% of controls (p<0.003). Uric acid correlated with RBS (r=0.29, p=0.02) and, more strongly, with HbA1c (Spearman ρ=0.690, p<0.001). Women who required insulin had higher mean uric acid than those managed on medication alone (6.70±0.86 versus 5.35±1.18 mg/dl; p<0.001). ROC analysis gave an area under the curve of 0.7325, with an optimal cut-off of ≥5.1 mg/dl (sensitivity 71.67%, specificity 66.67%). Conclusions: Maternal serum uric acid was associated with GDM and with markers of poorer glycemic control and greater treatment intensity. It may be a useful adjunctive biomarker, but its moderate discriminatory power means it cannot stand alone as a diagnostic test.