Common obesity-related anthropometric indices and the risk of gestational diabetes mellitus in a Chinese population: a prospective cohort study.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8807913 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-0766 (Electronic) Linking ISSN: 09513590 NLM ISO Abbreviation: Gynecol Endocrinol Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: [Carnforth, Lancashire ; Park Ridge, N.J.] : Parthenon Pub., [c1987-

Diabetes, Gestational*/epidemiology ; Body Mass Index* ; Obesity*/epidemiology ; Obesity*/complications; Humans ; Female ; Pregnancy ; Adult ; Prospective Studies ; China/epidemiology ; Waist-Hip Ratio ; Risk Factors ; Intra-Abdominal Fat/diagnostic imaging ; Waist-Height Ratio ; Pregnancy Trimester, First ; Anthropometry/methods ; Cohort Studies ; East Asian People

Objective: Anthropometric measurement provides a simple, noninvasive approach to evaluate obesity in pregnant women. We aimed to develop a predictive model utilizing anthropometric index for gestational diabetes mellitus (GDM), the most common obesity-related complications during pregnancy.
Methods: A prospective cohort of 4709 women was enrolled in Qingdao, China. Logistic regression model was constructed to determine the association of body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) in the first trimester (<14 weeks' gestation) with GDM. The discrimination ability for GDM was assessed using areas under the receiver operating characteristic (ROC) curve (AUC). Delong tests were performed to compare AUC values between different measures.
Results: The GDM incidence was 19.50%. GDM risk increased with VAT during early pregnancy, and the risk increased by 117% (OR = 2.17, 95% CI: 1.23-2.83) to 326% (OR = 4.26, 95% CI: 2.29-7.91) in pregnant women with the second quartile or above after adjusting for confounders (all p <.05). Combined index using VAT and BMI demonstrated superior predictive power for GDM compared with BMI alone ( p <.05), but didn't differ from VAT ( p> .05). Overall, VAT was positively correlated with GDM occurrence, outperforming BMI, WHR, WHtR and SAT in the predicative model. A first-trimester VAT cutoff of 27.05 mm might be promising for GDM risk stratification.
Conclusions: First-trimester routine ultrasound screening may facilitate earlier identification and intervention of GDM. Pregnant women with VAT above the optimal threshold (27.05 mm) might benefit from targeted GDM monitoring.

Keywords: Gestational diabetes mellitus; abdominal obesity; anthropometric index; body fat distribution; visceral adipose tissue

Date Created: 20240813 Date Completed: 20240813 Latest Revision: 20240813

20240813

10.1080/09513590.2024.2390848

39135447