HOMA‐IR as a risk factor of gestational diabetes mellitus and a novel simple surrogate index in early pregnancy

Author(s):  
Shuoning Song ◽  
Yuemei Zhang ◽  
Xiaolin Qiao ◽  
Yanbei Duo ◽  
Jiyu Xu ◽  
...  
2009 ◽  
Vol 47 (S1) ◽  
pp. 83-89 ◽  
Author(s):  
Vicentia C. Harizopoulou ◽  
Alexandros Kritikos ◽  
Zisis Papanikolaou ◽  
Evangelia Saranti ◽  
Dimitrios Vavilis ◽  
...  

2020 ◽  
pp. 1-4
Author(s):  
Omaima H. Getlawi ◽  
Vellanki. Lakshmi narasamma ◽  
Salima M. Hawda ◽  
Musa O. Busarira ◽  
Eman E. Fadeel ◽  
...  

Background Vitamin D deficiency is a common occurrence, which affects maternal health during pregnancy. Evidence is accumulating for a role of a low level of vitamin D during the early pregnancy as a risk factor for the development of gestational diabetes mellitus (GDM). Our objectives are to describe the patterns of vitamin D levels in early pregnancy in mothers attending main antenatal services in Ajdabiya city, during the first quarter of the year 2017 and to examine the relationship between vitamin D levels and glucose metabolic derangements in pregnant women among the above-described population. Methods A cohort study was conducted in healthy pregnant women attending routine antenatal care in Ajdabiya city in 2017. All mothers were screened for serum 25 (OH) D level and glycated hemoglobin (HbA1c) and anthropometric by the time of booking during the first trimester (gestational age "GA" 7-15th week of pregnancy). All women with low 25 (OH) D level were screened for GDM with non-fasting post-challenge blood glucose and confirmed by OGTT according to the American Diabetes Association (ADA) classification of GDM criteria in their 2nd trimester. Data was analyzed by using SPSS, IBM 20.0. Results All mothers in the study population were Libyan, their ages ranged from 18-43 years. Parity ranged from nulliparous to P10. More than 60% of mothers were housewives while others were either working or students and considered as having an outdoor lifestyle. In the first trimester, we detected 412 mothers had serum vitamin D3 below normal, the majority of cases had deficient serum 25 (OH) D (391, 94.9%) while 21 (5.1%) women had an insufficient serum 25 (OH) D. Serum 25 (OH) D ranged from 5.9-30.0 ng/ml. In the 2nd trimester, we confirmed 43 (10.43%) pregnant women with GDM out of 391 women with deficient serum 25 (OH) D level. 25 (OH) D deficiency was statistically significant (p = 0.035, OR = 0.963, 95% CI = 0.881-0.996) and associated with all GDM cases. Conclusion We conclude that 25 (OH) D deficiency was significantly correlated with GDM, as a consequence, the deficiency of 25 (OH) D could act as a risk factor for GDM. This result implies the necessity of focusing on vitamin D3 supplementation for women of childbearing age.


Author(s):  
Yi Wang ◽  
Fengjiang Sun ◽  
Ping Wu ◽  
Yichao Huang ◽  
Yi Ye ◽  
...  

Abstract Context While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR=0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend =0.043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR=1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend =0.010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate adjusted P<0.05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusions Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.


2020 ◽  
Vol 8 (1) ◽  
pp. e001234
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Junko Kasai ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
...  

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.


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