Gestasyonel diabetes mellitus gelişimini öngörmede ilk trimester maternal Ca 19-9 düzeyleri

Amaç. Birinci trimester serum CA-19-9 seviyelerinin gestasyonel diabetes mellitus (GDM) gelişecek olguları önceden saptamakta kullanılıp kullanılamayacağını araştırmak. Yöntem. Gebeliğinin ilk trimesterinde serum CA 19-9 seviyeleri ölçülmüş olan, takibi kliniğimizde yapılan, ikinci trimesterde standart GDM taraması yapılan ve bilinen herhangi bir hastalığı olmayan tüm gebeler retrospektif olarak incelendi. Toplam 144 gebe kadının bilgilerine hasta dosyalarından ulaşıldı. GDM olan, 100 gramlık oral glukoz tolerans testinde bir değeri yüksek olan ve normal glukoz toleransı olan olgular CA 19-9 seviyeleri bakımından karşılaştırıldı. Bulgular. GDM görülme sıklığı %2.8, bozulmuş glukoz tolerans sıklığı %4.9 olarak bulundu. CA 19-9 olguların %4,2'sinde yüksek olarak saptandı. CA 19-9 seviyeleri ve yükseklik durumu bakımından glukoz toleransı normal, bozulmuş ve GDM olan olgular karşılaştırıldığında istatistiksel olarak anlamlı bir fark bulunamadı. GDM olup olmama durumu ile CA 19-9'un yüksek veya normal sınırlarda olma durumu arasındaki korelasyon analizinde r=-0,035 bulunarak istatistiksel olarak anlamsız şeklinde değerlendirildi (p=0.672). Sonuç. Çalışmamızda bilindiği kadarıyla ilk defa, pankreas dokusu hakkında fikir veren bir tümör belirteci olan CA 19-9 ile GDM arasındaki ilişki incelenmiş ve gebeliğin birinci trimesterinde ölçülen CA 19-9 seviyeleri ile GDM arasında herhangi bir ilişkinin olmadığı görülmüştür.

First trimester maternal CA 19-9 levels in the prediction of gestational diabetes mellitus

Aim. To investigate whether first trimester maternal serum CA 19-9 levels can be used to detect the patients who will develop gestational diabetes mellitus (GDM). Methods. All the pregnant women without a known systemic disease whose CA 19-9 levels were measured during their first trimester visits and whose follow-ups were done in our clinics were enrolled. The data of all 144 eligible cases were gathered from their files. Pregnant women who had normal glucose tolerance, who had only one high measurement during 100 g oral glucose test and who had GDM were compared with respect to CA 19-9 levels. Results. The prevalence of GDM and impaired glucose tolerance was found to be 2.8% and 4.9% respectively. CA 19-9 was above the cut-off in 4.2% of the cases. No statistically significant difference was found with respect to CA 19-9 levels between pregnant women with normal tolerance, impaired glucose tolerance and GDM. The phi correlation coefficient between presence of GDM and having a CA 19-9 level above the cut-off was found to be -0.035 which was not statistically significant (p=0.672). Conclusion. To our knowledge, in this study the relationship between CA 19-9 levels, which provide information about the pancreas tissue, and GDM was investigated for the first time and no relationship was found between first trimester CA 19-9 levels and GDM.

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