الفهرس 
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Abstract
Gestational diabetes mellitus (GDM) constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2DM to the mother and fetus later in life. Currently, “universal screening” is recommended for GDM at 24–28 weeks of gestation by oral glucose tolerance tests (OGTTs). However, the current approach of diagnosis and treatment during the late second or early third trimester of pregnancy using OGTTs fails to prevent the “pathology” that is already well established and the adverse effects on long-term outcomes. Several lines of investigation indicate that the HLA‐G molecule is involved in the maternal acceptance of the semi‐allogenic fetus during pregnancy and in the development of tolerance. Expression of soluble HLA‐G (sHLA‐G) is positively correlated with successful in vitro fertilization (IVF) treatments, and aberrant expression of HLA‐G in certain complications of pregnancy, such as pre‐eclampsia and spontaneous abortion, has been reported However, there is a scarcity in the published literature that directly compares the diagnostic utility of HLA-G in GDM. Thus, we conducted the present case-control study in order to evaluate the role of soluble HLA-G in women with gestational diabetes compared with healthy controls.
The case-control study was performed at Gestational Diabetes Mellitus (GDM) Outpatient Clinic of Assiut University Hospital (Hospital of Woman Health) in period between November 2018 and November 2019. The study enrolled 96 pregnant women at 24th to 28th age of gestation. Those women were subdivided into two groups based on oral glucose tolerance test;
• Study group included 60 pregnant women with GDM
• Control group included 36 pregnant women with no GDM
In the present study, the mean age of the of women with GDM was 31.13 ± 6.41 years with. In the present study, the mean body mass index was significantly higher among those women with GDM in comparison to the control group (26.56 ± 5.55 vs. 21.12 ± 4.56 kg/m2; P= 0.01). In our cohort, family history of DM was significantly higher among those with GDM than control groups (8 (13.33%) vs. 2 (5.5%); P= 0.04).
Regarding the primary outcome of the present study, the current study showed that pregnant women with GDM had significantly higher HLA-G in comparison to those without GDM (1.93 ± 0.19 vs. 0.21 ± 0.16; P< 0.001). It was noticed that for diagnosis of GDM, HLA-G at cut off point> 0.7 had 94% sensitivity and 91% with overall accuracy was 93%.
We acknowledge that the present study has some limitations. The study was limited to Assiut University hospital only and therefore the results cannot be generalized to the general Egyptian population. The descriptive nature of the present study may also preclude the conclusion of association analysis.