Serum neudesin is elevated in pregnancies complicated by pregestational type 2 diabetes: an exploratory cross-sectional controlled study : Neudesin in pregestational diabetes during pregnancy.

objectiveNeudesin has been linked to adipose tissue activity, glucose metabolism, and insulin resistance. Evidence on its behavior in diabetic pregnancies is limited, particularly in women with pregestational type 2 diabetes mellitus (PREGDM). This exploratory cross-sectional controlled study evaluated serum neudesin concentrations in pregnancies complicated by pregestational type 2 diabetes mellitus (PREGDM) or gestational diabetes mellitus (GDM), and in non-diabetic pregnant controls without major systemic disease, while examining the influence of gestational timing.

methodsThis study included 90 pregnant women: 30 with PREGDM, 30 with GDM, and 30 non-diabetic controls without major systemic disease. Controls were recruited in two planned gestational-age strata, including early pregnancy and 24-28 weeks, to provide clinically relevant timing-aware comparisons. Serum neudesin concentrations were measured using a human neudesin enzyme-linked immunosorbent assay kit (BT LAB, catalogue no. E4258Hu) and reported as ng/mL. Overall group comparisons were supplemented by gestational-timing-aware analyses and exploratory multivariable log-neudesin regression.

resultsOverall median serum neudesin was highest in the PREGDM group (5.67 [4.72-6.21] ng/mL), followed by the GDM group (2.80 [2.70-3.10] ng/mL) and controls (2.17 [1.77-2.89] ng/mL; p < 0.001). In gestational-timing-aware comparisons, PREGDM remained higher than early-pregnancy controls (5.67 [4.72-6.21] vs. 1.70 [1.37-2.15] ng/mL; Hodges-Lehmann difference, 3.70 ng/mL; 95% CI, 3.15-4.35; p < 0.001). In contrast, GDM did not differ from controls sampled at 24-28 weeks (2.80 [2.70-3.10] vs. 2.85 [2.28-3.03] ng/mL; Hodges-Lehmann difference, 0.04 ng/mL; 95% CI, - 0.20 to 0.40; p = 0.791). In the diabetic-only model adjusted for gestational age and age, the PREGDM-GDM contrast was attenuated (GMR, 1.31; 95% CI, 0.61-2.85; p = 0.490). In the all-participant adjusted model, PREGDM remained associated with higher neudesin than controls (GMR, 3.11; 95% CI, 2.57-3.76; p < 0.001), whereas the GDM-control contrast was not significant (GMR, 1.12; 95% CI, 0.96-1.30; p = 0.149).

conclusionSerum neudesin was most consistently elevated in pregnancies complicated by PREGDM. The apparent overall GDM-control difference was not retained after timing-aware comparison or adjustment. Given the modest sample size, neudesin should be considered an exploratory complementary metabolic marker rather than a standalone diagnostic biomarker.