The pathophysiology of gestational diabetes mellitus (GDM) remains not fully understood, but recent research points to a proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) as significant players in its development. A longitudinal observational study published in 'Diabetes and Metabolic Syndrome: Clinical Research and Reviews' monitored women from the first trimester through 24–28 weeks of gestation, focusing on the development of GDM. In this study, researchers evaluated serum levels of BAFF and APRIL, along with their mRNA expression, in both the first and third trimesters. They also assessed cytokines, adipokines, and placental hormones in the serum. Despite the mRNA expression of these molecules being equivalent to controls, women who later developed GDM exhibited higher serum BAFF and lower serum APRIL levels in the first trimester. Significant positive associations were found between placental hormones, metabolic indicators, and serum BAFF. Conversely, there was a positive correlation between serum APRIL and adiponectin, and a negative correlation with insulin resistance and inflammatory markers.

      As the pregnancy progressed into the third trimester, GDM participants continued to show lower blood APRIL levels and higher serum BAFF levels compared to controls. Although BAFF mRNA expression did not significantly differ between the GDM and control groups, the GDM group showed considerably reduced levels of APRIL mRNA expression. First-trimester levels of BAFF and APRIL were also analyzed for their predictive ability, demonstrating strong potential as early biomarkers for GDM.

      This study suggests that elevated serum BAFF and reduced serum APRIL levels during pregnancy may be associated with the development of GDM, positioning these biomarkers as potential early predictors for the condition.