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Spearman\u2019s correlation was used to assess associations between glycemic markers and glucose levels. Predictive performance for GDM was evaluated using ROC analysis, and stratified analyses were conducted by pre-pregnancy BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 191 participants, 45 (24.1%) developed GDM: 35.1\u2009\u00b1\u20094.9\u00a0years, pre-pregnancy BMI 22.9\u2009\u00b1\u20094.3\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and sampling at 14.3 [IQR 14.0\u201314.7] weeks. HbA1c correlated with fasting glucose (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.35) while 1,5-AG correlated inversely with 2-h glucose (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2009\u2212\u20090.39). They themselves were not significantly correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2009\u2212\u20090.13). As single predictors, performance depended on BMI: in\u2009\u2265\u200925.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , HbA1c outperformed 1,5-AG (AUC 0.776 vs 0.618); in BMI\u2009&lt;\u200925.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 1,5-AG outperformed HbA1c (AUC 0.704 vs 0.640). In both BMI strata, the dual-marker model was superior (AUC 0.833 and 0.803, respectively) and provided more balanced sensitivity, accuracy, and F1. Pre-pregnancy BMI correlated positively with fasting plasma glucose (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.47) but not with 1-h or 2-h glucose (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.20 and\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.16, respectively), supporting BMI-related metabolic variation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combining 1,5-AG and HbA1c enhances early prediction of GDM by capturing complementary glycemic abnormalities linked to BMI-specific metabolic phenotypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-025-08281-3","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T06:22:34Z","timestamp":1767421354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Synergistic use of 1,5-AG and HbA1c for early prediction of gestational diabetes: capturing BMI-dependent glycemic phenotypes"],"prefix":"10.1007","volume":"313","author":[{"given":"Sho","family":"Tano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Inamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Fuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiko","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Imai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Katsuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Kishigami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Oguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Kotani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takafumi","family":"Ushida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kajiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"issue":"12","key":"8281_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-019-1267-6","volume":"19","author":"ME Bianco","year":"2019","unstructured":"Bianco ME, Josefson JL (2019) Hyperglycemia during pregnancy and long-term offspring outcomes. 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