Background: Gestational diabetes mellitus (GDM) is a common endocrine complication in
pregnancy. While it has been established that age, family history of diabetes, insulin resistance and several
biomarkers are associated with GDM but significant gaps remain in understanding risk factors for
GDM. Soluble pro-renin receptor (s [Pro] RR) as a biomarker reflects the activation of renin-angiotensin
system in tissues which may be related to insulin resistance
Objective: The aim of this study was to determine the role of (s [pro] RR) in predicting GDM.
Methods: one hundred-eighty singleton pregnant women in first trimester were enrolled. We excluded
women with previous history of GDM, hypertension and consumption of drugs affected reninangiotensin
system. A fasting blood glucose and s (pro) RR level were obtained during first trimester
and OGTT was performed at 24-28 weeks of gestation. We used ROC curves to identify s (pro) RR cutoff
points for detecting GDM and the difference in s (pro)RR level was assessed in GDM and non-
Results: Among 180 women, 24 (13.33%) had GDM. There was no significant difference between age
and body mass index in subjects with GDM compared to non- GDM. The concentration of s (pro) RR
was significantly higher in GDM subjects rather than non- GDM [29.27(24.60-35.92) vs. 22.89(19.46-
24.27), P<0.001]. Multiple logistic regression analysis revealed a significant association of s(pro) RR
with GDM (odd ratio: 1.32, 95% CI: 1.17-1.48, P=0.04). A cut-off point 24.52 ng/ml of s(pro) RR had
75% sensitivity and 80% specificity for predicting GDM.
Conclusion: Increased level of s (pro) RR in first trimester may be a marker for predicting GDM.