Elevated first-trimester uric acid concentrations are associated with the development of gestational diabetes.

Abstract

We sought to demonstrate that elevated first-trimester uric acid is associated with development of gestational diabetes mellitus (GDM). Uric acid was measured in 1570 plasma samples collected at mean gestational age of 8.9 +/- 2.5 weeks. The primary outcome was GDM, diagnosed by 3-hour glucose tolerance test using Carpenter and Coustan criteria or by a 1-hour value of > or =200 mg/dL. Logistic regression was performed, adjusting for relevant covariates. Almost half (46.6%) of the women with GDM had first-trimester uric acid concentrations in the highest quartile (>3.57-8.30 mg/dL). Women with uric acid in the highest quartile had a 3.25-fold increased risk (95% confidence interval, 1.35-7.83) of developing GDM after adjustment for body mass index and age. This effect was concentration dependent as risk increased with increasing uric acid quartiles (P = .003). First-trimester hyperuricemia is associated with an increased risk of developing GDM, independent of body mass index.