Journal of Obstetrics and Gynaecology最新文献

{"title":"DNA methylation triage of human papillomavirus-positive atypical squamous cells of undetermined significance in cervical cancer screening.","authors":"Weiwei Xia, Jing Wang, Xiaoxiao Yang, Ying Sha, Fang Hou, Jie Li, Zhenghua Teng, Juan Wang, Fangrong Shen, Peng Jie","doi":"10.1080/01443615.2026.2623828","DOIUrl":"10.1080/01443615.2026.2623828","url":null,"abstract":"<p><strong>Background: </strong>Triage of human papillomavirus (HPV)-positive women with atypical squamous cells of undetermined significance (ASC-US) remains a longstanding clinical challenge in cervical cancer screening, as conventional strategies often lead to excessive colposcopy referrals. We conducted a diagnostic cohort study of 195 HPV-positive women who underwent ASC-US cytology.</p><p><strong>Methods: </strong>Multigene DNA methylation analysis was performed on residual cervical exfoliated cells, using histology from colposcopy-directed biopsy and/or endocervical sampling as the reference standard to minimise colposcopy referrals.</p><p><strong>Results: </strong>Our results showed that methylation levels of PAX1, EPB41L3, and FAM19A4 increased progressively from ≤ CIN1 to CIN2, CIN3, and cervical cancer, with significant decreases in ΔCt values from ≤ CIN1 to CIN3 for all three genes (<i>p</i> < 0.05). For detection of CIN2+, the assay achieved a sensitivity of 85.19%, specificity of 96.43%, positive predictive value (PPV) of 79.31%, negative predictive value (NPV) of 97.59%, and an area under the receiver operating characteristic curve (AUC) of 0.91, thereby avoiding colposcopy referrals in 96.43% (162/168). For CIN3+, the assay demonstrated sensitivity, specificity, PPV, NPV, and AUC values of 94.44%, 93.22%, 58.62%, 99.4%, and 0.94, respectively. Stratified analyses showed high and comparable sensitivity (81.82% vs. 87.50%), specificity (96.92% vs. 96.12%), and AUC (0.89 vs. 0.92) in women with HPV16/18 compared with those with non-16/18 high-risk HPV. Optimal diagnostic accuracy was observed in women aged ≥30 years, with sensitivities ranging from 85.70% to 100%, specificities from 94.44% to 100%, and AUC values ranging from 0.93 to 0.97. In contrast, the performance was suboptimal in women aged <30 years (sensitivity, 33.33%; AUC, 0.64).</p><p><strong>Conclusions: </strong>The host multigene DNA methylation assay demonstrates high specificity and good sensitivity for triaging HPV-positive ASC-US women, with the potential to reduce colposcopy referrals while maintaining robust detection of high-grade lesions, particularly in those aged ≥30 years.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2623828"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes remission in gynaecologic oncology patients completing an acute preoperative weight loss protocol: a case series.","authors":"Haley D Frerichs, Jenna B Wowdzia, Jesse Batara, Christa Aubrey, Sophia Pin, Sarah Chapelsky","doi":"10.1080/01443615.2026.2665632","DOIUrl":"10.1080/01443615.2026.2665632","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to review type 2 diabetes (T2D) remission and glycaemic improvement in gynaecologic oncology patients with class 3 obesity undergoing preoperative weight loss.</p><p><strong>Methods: </strong>This was a case series of 92 gynaecologic oncology patients with BMI ≥40 kg/m² and T2D who underwent preoperative weight loss with a low-calorie liquid meal replacement. Patients were classified as high or low likelihood of remission based on diabetes duration, glycated haemoglobin (A1C) and insulin use. Data were summarised descriptively and Fisher's exact test and paired <i>t</i>-test were used as inferential statistics using SAS 9.4.</p><p><strong>Results: </strong>Twenty-one patients with a mean age of 57.8 (SD = 11.7) years completed a weight loss protocol of median 14 (IQR = 10.5-16.5) weeks. Eighteen (86%) had endometrioid endometrial carcinoma or atypical endometrial hyperplasia. Initial mean BMI and A1C were 48.0 (SD = 6.7) kg/m² and 8.2% (SD = 2.3%). After the protocol, mean BMI and A1C were 43.1 (SD = 5.5) kg/m² and 7.1% (SD = 1.7%). On average, A1C decreased 1.1% (95% CI: 0.5-1.6, <i>p</i> < 0.05) after weight loss. 3/21 patients experienced diabetes remission. The rate of remission was 2/6 and 1/15 for patients coded as high and low likelihood of remission (<i>p</i> = 0.18).</p><p><strong>Conclusions: </strong>Weight, BMI and A1C were significantly reduced by preoperative weight loss in gynaecologic oncology patients with T2D. There was a low rate of diabetes remission, with most patients having clinical characteristics predictive of a low likelihood of remission.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2665632"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Metformin in the treatment of clomiphene citrate-resistant women with polycystic ovary syndrome undergoing <i>in vitro</i> fertilisation treatment: A randomised controlled trial.","authors":"","doi":"10.1080/01443615.2026.2715902","DOIUrl":"https://doi.org/10.1080/01443615.2026.2715902","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2715902"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory markers and the systemic immune-inflammation index in endometrial carcinoma and hyperplasia: a retrospective cohort study.","authors":"Funda Atalay, Cemal Reşat Atalay, Uğurcan Zorlu, Tufan Arslanca","doi":"10.1080/01443615.2026.2705901","DOIUrl":"https://doi.org/10.1080/01443615.2026.2705901","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometrial carcinoma (EC) presents commonly with abnormal uterine bleeding, and definitive diagnosis requires invasive endometrial biopsy. Haematological inflammatory markers-including the neutrophil-to-lymphocyte ratio (NLR), platelet distribution width (PDW), and the systemic immune-inflammation index (SII)-have been proposed as adjuncts in the differential diagnosis of endometrial pathologies. We evaluated whether these markers can independently discriminate EC from endometrial hyperplasia with atypia/endometrial intraepithelial neoplasia (EHA/EIN), endometrial hyperplasia without atypia (EH), and normal endometrium, after adjustment for age and other confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 238 patients who underwent endometrial biopsy for abnormal uterine bleeding between 2015 and 2020 were retrospectively analysed. Patients were categorised as EC (&lt;i&gt;n&lt;/i&gt; = 74), EHA/EIN (&lt;i&gt;n&lt;/i&gt; = 28), EH without atypia (&lt;i&gt;n&lt;/i&gt; = 66), and controls with normal endometrium (&lt;i&gt;n&lt;/i&gt; = 70). Haematological parameters, NLR, platelet-to-lymphocyte ratio (PLR), and SII were derived from preoperative complete blood count results. Univariable comparisons used the Kruskal-Wallis test with Dunn's post-hoc pairwise comparisons. Hierarchical multivariable logistic regression models were fitted, adjusting sequentially for age, menopausal status, and (where available) diabetes mellitus and hypertension. Receiver operating characteristic (ROC) analysis was performed for markers showing significant univariable discrimination, and PDW was analysed in inverted form (1-PDW direction) to reflect its inverse association with malignancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;NLR and SII were significantly elevated, and PDW was significantly reduced, in EC patients compared with controls (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). After adjustment for age and menopausal status, NLR (adjusted OR [aOR] 2.06, 95% CI 1.04-4.09; &lt;i&gt;p&lt;/i&gt; = 0.037), SII per 100 units (aOR 1.49, 95% CI 1.09-2.04; &lt;i&gt;p&lt;/i&gt; = 0.014) and PDW (aOR 0.93, 95% CI 0.89-0.96; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) remained independently associated with EC versus controls. By contrast, after adjustment for age, NLR and SII no longer independently discriminated EC from EH (NLR aOR 1.27, &lt;i&gt;p&lt;/i&gt; = 0.245; SII aOR 1.14, &lt;i&gt;p&lt;/i&gt; = 0.165), suggesting that age accounts for a substantial proportion of the apparent univariable differences. In ROC analysis with PDW values inverted, AUCs were 0.79 (95% CI 0.72-0.87) for PDW, 0.68 (95% CI 0.59-0.76) for NLR, and 0.62 (95% CI 0.52-0.70) for SII against the control group. No marker-adjusted or unadjusted-significantly distinguished EC from EHA/EIN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;NLR, SII, and (low) PDW are independently associated with EC compared with normal endometrium, even after age and menopausal status adjustment, but their performance is modest and they do not independently discriminate EC from premalignant endometrial lesions. Histopathological evaluation remai","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2705901"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of platelet-to-lymphocyte ratio and lymphocyte with HPV infection in adult women: a cross-sectional analysis.","authors":"Mei Wei, Ruirui Yu, Zheng'ai Xiong, Yuanyuan Hua","doi":"10.1080/01443615.2026.2725024","DOIUrl":"https://doi.org/10.1080/01443615.2026.2725024","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) infection represents a major public health concern worldwide. Inflammatory indicators have been associated with various disease conditions. However, the associations of platelet-to-lymphocyte ratio (PLR), platelet (PLT), and lymphocyte (LYM) with HPV infection remain unclear. This study aimed to investigate the relationships between PLR, PLT, LYM, and HPV infection.</p><p><strong>Methods: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. PLR was calculated as PLT/LYM. Multivariable logistic regression was performed to evaluate the associations between PLR and HPV infection. Receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC). Restricted cubic spline (RCS) analysis was applied to assess the association between LYM and HPV infection, and subgroup analyses with interaction tests were conducted.</p><p><strong>Results: </strong>Among 5,415 adult females included in this study, 2,301 had HPV infection, and 3,114 did not. When PLR was analysed as a continuous variable, multivariable logistic regression showed a significant inverse association with HPV infection (odds ratio [OR] = 0.99). After categorising PLR into quartiles, participants in the highest PLR quartile (Q4: 143.70-477.14) showed lower odds of HPV infection compared with those in the lowest quartile (Q1: 12.86-92.60). The AUC values were 0.53, 0.64, and 0.72 for models I, II, and III, respectively. No significant association was observed between PLT and HPV infection. In contrast, LYM showed a significant positive association with HPV infection, with RCS analysis indicating a linear relationship. Interaction analysis suggested that this association varied according to PIR.</p><p><strong>Conclusion: </strong>Higher PLR was associated with lower odds of HPV infection, whereas higher LYM levels were associated with higher odds of HPV infection. These findings provide additional evidence regarding the associations between inflammatory indicators and HPV infection.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2725024"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: The effects of somatostatin in the polycystic ovary syndrome.","authors":"","doi":"10.1080/01443615.2026.2732298","DOIUrl":"https://doi.org/10.1080/01443615.2026.2732298","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2732298"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocyte markers with CA125 and HE4 for diagnosing early endometrial cancer in postmenopausal women: case-control study.","authors":"Cheng Hong Xie, Hua Rong Cao","doi":"10.1080/01443615.2026.2719764","DOIUrl":"https://doi.org/10.1080/01443615.2026.2719764","url":null,"abstract":"<p><strong>Background: </strong>Endometrial cancer (EC) is common in postmenopausal women, with early diagnosis critical for prognosis. Traditional tumour markers (CA125, HE4) are limited alone, and the diagnostic value of peripheral blood lymphocyte-related indicators is unclear. This study explored the value of combining these lymphocyte indicators with CA125, HE4 and metabolic factors for early EC diagnosis in postmenopausal women.</p><p><strong>Methods: </strong>This is a single-centre case-control study that included 72 postmenopausal women with early EC (FIGO I-II, EC group) and 72 with benign uterine lesions (BL group). Baseline data, immunological markers (lymphocyte count, LYM; lymphocyte-to-monocyte ratio, LMR), CA125 and HE4 were measured. Receiver operating characteristic curves were used to analyse diagnostic performance, and multivariate logistic regression compared model fit.</p><p><strong>Results: </strong>The EC group had higher rates of diabetes, hypertension and dyslipidaemia (all <i>p</i> < .05), lower LYM and LMR (all <i>p</i> < .01) and higher CA125 and HE4 (all <i>p</i> < .001). Among single markers, HE4 had the highest area under the curve (AUC, 0.725) but low sensitivity (45.8%). The combination of CA125 and HE4 achieved an AUC of 0.759; adding LYM and LMR increased this to0.839. Incorporating metabolic factors further increased the AUC to 0.865 (Akaike information criterion, AIC = 144), which was superior to other models (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Combining lymphocyte indicators (LYM, LMR), CA125, HE4 and metabolic factors significantly improved early EC diagnostic efficacy in postmenopausal women, offering a reliable non-invasive strategy.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2719764"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"King's Mill anterior-posterior and transverse versus paracervical block in operative outpatient hysteroscopy: a randomised trial.","authors":"Raphael Laiyemo, Mohamed Saleh","doi":"10.1080/01443615.2026.2723309","DOIUrl":"10.1080/01443615.2026.2723309","url":null,"abstract":"<p><strong>Background: </strong>Pain control during operative outpatient hysteroscopy remains a clinical challenge, with the paracervical block (PCB) showing inconsistent efficacy. The King's Mill Anterior-Posterior and Transverse (KAPT) block targets the Lee-Frankenhauser plexus within the uterosacral ligament complex, where the highest density of uterine and cervical sensory fibres lies. We compared the KAPT block with the PCB in operative outpatient hysteroscopy.</p><p><strong>Methods: </strong>Single-centre, participant- and outcome assessor-blinded randomised controlled trial in a UK district general hospital. Forty-eight women undergoing operative outpatient hysteroscopy were randomised 1:1 to the KAPT block or the PCB, each delivered with 10 ml of prilocaine. Pain was measured on a 10-point Visual Analogue Scale (VAS) during the procedure and 10 minutes post-procedure (co-primary endpoints), and during cervical dilatation (exploratory). Analyses used the Mann-Whitney U test on an intention-to-treat basis, with Hodges-Lehmann median differences, percentile bootstrap 95% confidence intervals, and a hierarchical fixed-sequence testing strategy.</p><p><strong>Results: </strong>Median intra-procedural VAS was 1 (IQR 0 to 3) with the KAPT block versus 2 (IQR 1 to 6) with the PCB (Hodges-Lehmann median difference -1.00, 95% CI -3.00 to 0.00; p = 0.040). At 10 minutes post-procedure, median VAS was 0 (IQR 0 to 1.25) versus 2 (IQR 0 to 3.25) (median difference -1.00, 95% CI -2.00 to 0.00; p = 0.011). Both co-primary endpoints reached significance under hierarchical testing. Cervical dilatation pain did not differ significantly (p = 0.146). Satisfaction was 100% in both arms; willingness to recommend was 100% (KAPT) versus 95.8% (PCB). No serious adverse events occurred.</p><p><strong>Conclusions: </strong>The KAPT block was associated with lower intra-procedural and post-procedural pain than the PCB, with effect sizes consistent with a clinically meaningful difference. These findings support the KAPT block as a superior, anatomically targeted alternative to the PCB and justify evaluation in a larger multicentre trial.<b>Trial registration</b>: ISRCTN15619382.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2723309"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of Meridian sinew tuina (MST) for post-surgical upper limb lymphedema: a systematic review and meta-analysis.","authors":"Wenxia Zhao, Jin Yang, Yufei Hou, Min Li","doi":"10.1080/01443615.2026.2723314","DOIUrl":"10.1080/01443615.2026.2723314","url":null,"abstract":"<p><strong>Background: </strong>Complex Decongestive Therapy (CDT) is the non-operative standard for breast cancer-related lymphedema (BCRL), but many patients experience persistent subcutaneous stiffness, pain, and restricted mobility. This study systematically reviews the safety and clinical efficacy of Meridian Sinew Tuina (MST) protocols for BCRL.</p><p><strong>Methods: </strong>Global and regional databases (PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP) were searched from inception to January 15, 2026, with alerts monitored through April 30, 2026. Randomised controlled trials (RCTs) evaluating MST (deep tissue mobilisation along the six-hand meridian sinew [<i>Jingjin</i>] lines via plucking, kneading, and pressing) were included. Two reviewers independently extracted data, evaluated risk of bias using Cochrane RoB 2, and assessed evidence certainty via GRADE using a random-effects model.</p><p><strong>Results: </strong>Fifteen RCTs were included. For the primary anthropometric outcome, MST significantly reduced upper limb circumference compared to controls (SMD = 1.59; 95% CI: 1.44 to 1.74; Z = 20.81; p < 0.0001; <i>I</i>²=0.0%; N = 924; GRADE: <i>Moderate certainty</i>). The Clinical Response Efficacy Rate (≥ 30% swelling reduction and symptom relief) favoured MST (RR = 1.69; 95% CI: 1.54 to 1.87; Z = 10.62; p < 0.0001; <i>I</i>²=0.0%; N = 1,114; GRADE: <i>Moderate certainty</i>). Trial Sequential Analysis confirmed sample size sufficiency. For secondary outcomes (N = 924; GRADE: <i>Low to Very Low certainty</i> due to performance bias and clinical heterogeneity), MST showed favourable 3-month improvements in DASH functional scores (SMD = -1.81; 95% CI: -2.11 to -1.51; <i>I</i>²=45.1%), pain intensity (SMD = -2.44; 95% CI: -2.93 to -1.95; <i>I</i>²=50.4%), and quality of life (SMD = 1.04; 95% CI: 0.79 to 1.29; <i>I</i>²=0.0%). No serious adverse events occurred.</p><p><strong>Conclusions: </strong>MST protocols are associated with favourable short- and mid-term reductions in upper limb swelling. However, confidence is tempered by unblinded performance bias and control group variations. MST cannot be unconditionally recommended for standalone implementation but represents a promising, optional supportive adjunctive intervention within oncological rehabilitation.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2723314"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agouti signalling protein and triglyceride-glucose index in early pregnancy with gestational diabetes: a prospective cohort study.","authors":"Xue Wei, Hao Gong, Qian Zhang, Shuqin Dong, Jing Wei, Yu Lu","doi":"10.1080/01443615.2026.2665634","DOIUrl":"10.1080/01443615.2026.2665634","url":null,"abstract":"<p><strong>Objective: </strong>Agouti signalling protein (ASIP) is an adipokine regulating appetite and energy balance. This study aimed to investigate the association of first-trimester serum ASIP and triglyceride-glucose (TyG) index with the development of gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>This prospective study enrolled 231 singleton pregnant women (GDM, n = 42; non-GDM, n = 189). Serum ASIP, the TyG index, and routine metabolic parameters were measured during the first (8-12 gestational weeks) and second (24-28 gestational weeks) trimesters. GDM was diagnosed at 24-28 weeks via a standard 75-g oral glucose tolerance test.</p><p><strong>Results: </strong>Both serum ASIP levels and TyG index were significantly elevated in the GDM group compared to the non-GDM group during both trimesters (all P < 0.001). First-trimester ASIP and TyG index correlated positively with second-trimester fasting plasma glucose, 2-hour postprandial glucose, and homeostatic model assessment of insulin resistance, and inversely with quantitative insulin sensitivity check index and Bennett insulin sensitivity index (all P < 0.01). After adjustment, both ASIP and TyG index in the first trimester remained independent risk factors for GDM (ASIP: adjusted odds ratio [a OR] = 1.031, 95% confidence interval [CI] 1.015-1.047, P = 0.019; TyG: a OR = 5.445, 95% CI 1.936-15.319, P < 0.001), with consistent associations across age and body mass index subgroups (interaction P > 0.05). The combination of ASIP and TyG index in the first trimester yielded an AUC of 0.788 for GDM prediction, with a sensitivity of 76.2%, specificity of 68.8%, positive predictive value of 35.2%, and negative predictive value of 92.9%. Its predictive performance improved in the second trimester, achieving an AUC of 0.894, with corresponding values of 92.9%, 72.0%, 42.4%, and 97.9%, respectively.</p><p><strong>Conclusions: </strong>Elevated first-trimester serum ASIP and TyG index are associated with an increased risk of GDM, and correlate with increased insulin resistance and dysglycaemia during pregnancy.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2665634"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}