Objective To investigate the diagnostic value of combined detection of serum β-human chorionic gonadotropin（β-HCG）

pregnancy-associated plasma protein A（PAPP-A）

and adiponectin（ADP） in early pregnancy on gestational diabetes mellitus（GDM）. Methods A total of 134 pregnant women with GDM who attended a hospital in Guangzhou from August 2019 to March 2021 were selected as subjects for the experimental group. Another 140 healthy pregnant women who underwent prenatal examination in this hospital during the same period were selected as the controls. The levels of serum β-HCG

PAPP-A and ADP were compared between the two groups of pregnant women in early pregnancy. The correlation between the levels of β-HCG

PAPP-A and ADP and the levels of fasting blood glucose（FBG） and hemoglobin A1c（HbA1c） in pregnant women with GDM from 24 to 28 weeks of gestation was analyzed using the Pearson correlation coefficient. The single diagnostic efficacy and combined diagnostic efficacy of β-HCG

PAPP-A and ADP levels on GDM were compared. The independent risk factors for the occurrence of GDM were analyzed using the multivariate logistic regression analysis model. Results The levels of PAPP-A and ADP in early pregnancy in the experimental group were negatively correlated with the levels of FBG and HbA1c from 24 to 28 weeks of gestation（P<0.05）;the levels of β-HCG was not correlated with those of FBG and HbA1c（P>0.05）. The AUCs of β-HCG

PAPP-A

ADP and the three combined detection for the diagnosis of GDM were 0.551

0.670

0.686 and 0.752

respectively. The AUCs of β-HCG

PAPP-A

ADP and the combination of the three combined detection for the diagnosis of GDM were 0.551

0.670

0.686 and 0.752

respectively

and the AUCs of the three combined detection were greater than those of the single index diagnosis（P<0.05）. Multivariate regression analysis showed that age ≥35 years

pre-pregnancy BMI ≥25 kg/m~2

delivery ≥1

PAPP-A <1.37 MoM in early pregnancy

and ADP <9.80 mg/L in early pregnancy were all independent risk factors for the development of GDM（P<0.05）. Conclusion Compared with healthy pregnant women

there is no significant difference in serum β-HCG levels in pregnant women with GDM in early pregnancy

who have lower PAPP-A and ADP levels. The levels of PAPP-A and ADP are independent risk factors for the occurrence of GDM. The combined detection of β-HCG

PAPP-A and ADP should be used in diagnosing GDM clinically

and the management of pregnant women with a high risk of GDM should be strengthened to improve the pregnancy outcomes.