Association of Soluble (PRO) Renin Receptor with Gestational Diabetes Mellitus.

Objective: There is a need to identify biomarkers for gestational diabetes mellitus (GDM). Recently the soluble pro-renin receptor (s[Pro]RR) has been shown to be associated with GDM. We investigated the association of s(Pro) RR levels in Asian Indians with GDM. Methods: We recruited 222 pregnant females, 147 without GDM (non-GDM) and 75 with GDM visiting antenatal clinics in Tamilnadu in South India. We included singleton pregnancy and excluded those with pre-existing diabetes mellitus or hypertension. Oral glucose tolerance tests (OGTTs) were performed, and GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Group criteria. s(Pro) RR was measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were used to identify s(Pro) RR cut-off points to identify GDM. Results: The mean levels of the s(Pro) RR were significantly higher in subjects with GDM (34.0 +/- 12 ng/mL, P < .001) compared to non-GDM (21.4 +/- 6.5 ng/mL). The proportions of subjects with GDM were 11 (15%) in the first tertile of s(Pro) RR (<19.61 ng/mL), 20 (27%) in the second (19.62-26.8 ng/mL), and 44 (59%) in the third tertile (>26.8 ng/mL). In multiple logistic regression analysis, s(Pro) RR showed a significant association with GDM (odds ratio [OR]: 1.201, 95% confidence interval [CI]: 1.065-1.355, P = .003) after adjusting for potential confounders. A s(Pro) RR cut-off of 23.3 ng/mL had a C statistic of 0.828 (95% CI: 0.738-0.918, P < .001), sensitivity of 68%, and specificity of 70% to identify GDM. Conclusions: s(Pro) RR levels are higher in females with GDM, and this could be used as a potential biomarker.