Table 2.

Biomarkers under investigation in GDM.

Biomarker	Advantages	Disadvantages
Insulin Resistance	Elevations in first trimester are associated with higher risk of GDM prediction at 24–28 weeks in certain subpopulations of GDM women [71,72,73]	Not conclusively demonstrated as predictive in all studies [74]
Insulin sensitivity	Early studies demonstrate association with GDM [72]	Heterogeneity of calculation methods used in studies limits universal comparison [72]
SHBG	Inverse relationship with elevated insulin levels in first and second trimester of women who proceed to GDM development are demonstrated [75,76]	Significance is lost on multivariate analysis with clinical risk factors [75,76]
Lipids	Elevated triglycerides are seen in women with GDM Reductions in HDL levels are seen in association with GDM [77,78,79,80,81,82,83,84,85]	Predictive and diagnostic capacity is not yet demonstrated [77,78,79,80,81,82,83,84,85]
Inflammatory markers: TNF-α, CRP, IL-6	TNF-α, IL-6 and CRP are elevated in association with GDM [86,87,88,89,90,91,92,93,94,95]	Non-specific Lack of prospective data [86,87,88,89,90,91,92,93,94,95]
Placental GLUT	Altered in response to maternal hyperglycaemia [96,97,98]	Lacks prospective clinical utility [96,97,98]
Epigenetic markers	Several target sites are identified [99,100,101,102,103,104,105,106]	Further identification of epigenetic sites required Offers promise as tools for diagnosis [99,100,101,102,103,104,105,106]

Abbreviations: SHBG, sex hormone binding globulin; HDL, high density lipoprotein; TNF-α, tumour necrosis factor; CRP, C-reactive protein; IL-6, interleukin-6; GLUT, glucose transporter.