{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:12:08Z","timestamp":1789125128570,"version":"build-2803163510"},"reference-count":38,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":45,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore the role of the nuclear factor E2-related factor 2 (Nrf2)\u2013Kelch-like ECH-associated protein 1 (Keap1)\u2013antioxidant response element (ARE)\/heme oxygenase-1 (HO-1) signaling pathway in the development of gestational diabetes mellitus (GDM) during the first trimester and to evaluate its potential as an early predictor biomarker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective nested case\u2013control study including 97 matched pairs of GDM patients and healthy controls was conducted. Peripheral blood collected between gestational weeks 8 and 12 was analyzed for mRNA levels of Nrf2, Keap1, and HO-1 using quantitative real-time PCR (qRT-PCR) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the first trimester, the GDM group showed significantly higher levels of Nrf2 and HO-1 mRNA, while Keap1 expression was comparable to controls. Elevated Nrf2 mRNA levels were associated with a higher GDM risk (odds ratio (OR) = 2.369, 95% confidence interval (CI): 1.700\u20133.302, P &amp;lt; 0.001), with increased Nrf2 mRNA levels being positively linked to GDM development. Receiver operating characteristic (ROC) curve analysis indicated that first-trimester Nrf2 mRNA expression could predict mid-gestation GDM diagnosis with an area under the curve (AUC) of 0.770 (95% CI: 0.704\u20130.827).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the early trimester of pregnancy, individuals with GDM show a significant increase in the mRNA expression of Nrf2 and HO-1. Nrf2 mRNA serves as an independent predictor of GDM development, supporting its possible role in pathogenesis and potential utility for early screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-26-0077","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:25:45Z","timestamp":1778174745000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Nrf2 mRNA in the first trimester as a predictive biomarker for gestational diabetes mellitus"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1214-3844","authenticated-orcid":true,"given":"Xinli","family":"Zhong","sequence":"first","affiliation":[{"name":"Department of Obstetrics, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingya","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Baoji Central Hospital, Baoji, Shanxi, China 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-2949","authenticated-orcid":true,"given":"Ping","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"2026091106573146300_bib1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s42000-020-00193-y","article-title":"Clinical practice guidelines on diabetes mellitus and pregnancy: \u0399I. 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