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First-Trimester Blood Marker Fails To Predict Gestational Diabetes In 302 Women

A hormone tied to blood sugar control couldn't flag who would develop gestational diabetes, so BMI and age still matter most for early screening.

By Dr. Axe Editorial Team · October 27, 2026 · 1 source · Watch

A hormone called asprosin that rises in gestational diabetes cannot predict who will develop the condition when measured in the first trimester, according to a study published October 22, 2026 in PLOS One.

302women tracked

32.5%developed GDM

Researchers at Chiang Mai University Hospital in Thailand enrolled 302 low-risk women with single pregnancies between January and November 2025, drawing blood for asprosin at 10 to 14 weeks, then screening for gestational diabetes at 24 to 28 weeks via standard two-step glucose testing. Of the group, 98 women, or 32.5%, developed gestational diabetes. Average asprosin was nearly identical between groups: 59.4 ng/mL among those who developed it versus 59.7 ng/mL among those who did not. Predictive ability was near chance, with an area under the curve of 0.516 (1.0 is perfect, 0.5 is a coin flip). Maternal age (33.1 vs 30.7 years) and pre-pregnancy BMI (24.9 vs 23.0) showed modest but real predictive value instead. Asprosin rose with BMI along a curve, though BMI explained only 8.2% of the variation in asprosin across the group.

Asprosin, released mainly by fat tissue, signals the liver to release stored glucose and crosses into the brain to boost appetite. Women who later develop gestational diabetes often have subtle insulin resistance early on that doesn't surface clearly until mid-pregnancy. The authors propose elevated asprosin may be a consequence of gestational diabetes appearing later, not an early warning sign.

First-Trimester Asprosin: GDM vs No-GDM Groups

PLOS One, 2026, Inthavong et al.

This single-center Thai study means the reference ranges need testing in other populations before wider use. Asprosin wasn't re-measured at diagnosis, leaving open whether it gains value once the condition develops. It's observational: it shows a BMI-asprosin link, not proof one causes the other.

Dr. Axe’s Take

A single blood marker rarely replaces basic metrics like age and pre-pregnancy weight when it comes to flagging gestational diabetes risk, and this study backs that up. Pre-pregnancy BMI showed real predictive signal here, which is exactly where I'd put my energy if you're planning a pregnancy or already in your first trimester. Work on insulin sensitivity before conception with strength training, a lower-glycemic whole-food diet, and adequate protein at each meal. If you're already pregnant and carrying extra weight, ask your provider about earlier glucose monitoring, since that's the factor this study actually found useful.

— Dr. Axe

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Study summary

Who: 302 low-risk women with singleton pregnancies, ages 20-45, enrolled at 10-14 weeks of gestation in Thailand
Design: Prospective cohort study; blood drawn in first trimester, gestational diabetes assessed via two-step glucose screening at 24-28 weeks
Dose: Not applicable (observational biomarker measurement, not an intervention)
Primary result: Asprosin averaged 59.4 ng/mL in the 98 women (32.5%) who developed gestational diabetes versus 59.7 ng/mL in those who did not; AUC 0.516
Secondary: Maternal age (33.1 vs 30.7 years) and pre-pregnancy BMI (24.9 vs 23.0 kg/m2) were significant independent predictors; BMI explained 8.2% of variation in asprosin levels
Funding / conflicts: Funding not reported in the abstract. Conflict statement in the PubMed record: The authors have declared that no competing interests exist.
Date: Oct 22, 2026