Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus
Abstract
1. Introduction
2. Patients and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
- Zhu, Y.; Zhang, C. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: A Global Perspective. Curr. Diabetes Rep. 2016, 16, 7. [Google Scholar] [CrossRef] [PubMed]
- Szmuilowicz, E.D.; Josefson, J.L.; Metzger, B.E. Gestational Diabetes Mellitus. Endocrinol. Metab. Clin. N. Am. 2019, 48, 479–493. [Google Scholar] [CrossRef] [PubMed]
- Kjos, S.L.; Peters, R.K.; Xiang, A.; Henry, O.A.; Montoro, M.; Buchanan, T.A. Predicting future diabetes in Latino women with gestational diabetes: Utility of early postpartum glucose tolerance testing. Diabetes 1995, 44, 586–591. [Google Scholar] [CrossRef] [PubMed]
- Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet. Gynecol. 2018, 131, e49–e64. [Google Scholar] [CrossRef] [PubMed]
- Torloni, M.R.; Betrán, A.P.; Horta, B.L.; Nakamura, M.U.; Atallah, A.N.; Moron, A.F.; Valente, O. Prepregnancy BMI and the risk of gestational diabetes: A systematic review of the literature with meta-analysis. Obes. Rev. 2009, 10, 194–203. [Google Scholar] [CrossRef]
- Chu, S.Y.; Callaghan, W.M.; Kim, S.Y.; Schmid, C.H.; Lau, J.; England, L.J.; Dietz, P.M. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007, 30, 2070–2076. [Google Scholar] [CrossRef] [PubMed]
- Norman, J.E.; Reynolds, R.M. The consequences of obesity and excess weight gain in pregnancy. Proc. Nutr. Soc. 2011, 70, 450–456. [Google Scholar] [CrossRef] [PubMed]
- Bartha, J.L.; Marín-Segura, P.; González-González, N.L.; Wagner, F.; Aguilar-Diosdado, M.; Hervias-Vivancos, B. Ultrasound evaluation of visceral fat and metabolic risk factors during early pregnancy. Obesity 2007, 15, 2233–2239. [Google Scholar] [CrossRef]
- Martin, A.M.; Berger, H.; Nisenbaum, R.; Lausman, A.Y.; MacGarvie, S.; Crerar, C.; Ray, J.G. Abdominal visceral adiposity in the first trimester predicts glucose intolerance in later pregnancy. Diabetes Care 2009, 32, 1308–1310. [Google Scholar] [CrossRef]
- De Souza, L.R.; Berger, H.; Retnakaran, R.; Maguire, J.L.; Nathens, A.B.; Connelly, P.W.; Ray, J.G. First-Trimester Maternal Abdominal Adiposity Predicts Dysglycemia and Gestational Diabetes Mellitus in Midpregnancy. Diabetes Care 2016, 39, 61–64. [Google Scholar] [CrossRef]
- Bourdages, M.; Demers, M.; Dubé, S.; Gasse, C.; Girard, M.; Boutin, A.; Ray, J.G.; Bujold, E.; Demers, S. First-Trimester Abdominal Adipose Tissue Thickness to Predict Gestational Diabetes. J. Obstet. Gynaecol. Can. 2018, 40, 883–887. [Google Scholar] [CrossRef] [PubMed]
- Ray, J.G.; De Souza, L.R.; Park, A.L.; Connelly, P.W.; Bujold, E.; Berger, H. Preeclampsia and Preterm Birth Associated with Visceral Adiposity in Early Pregnancy. J. Obstet. Gynaecol. Can. 2017, 39, 78–81. [Google Scholar] [CrossRef] [PubMed]
- Thaware, P.K.; Patterson, C.C.; Young, I.S.; Casey, C.; McCance, D.R. Clinical utility of ultrasonography-measured visceral adipose tissue depth as a tool in early pregnancy screening for gestational diabetes: A proof-of-concept study. Diabet. Med. 2019, 36, 898–901. [Google Scholar] [CrossRef] [PubMed]
- Rahnemaei, F.A.; Abdi, F.; Pakzad, R.; Sharami, S.H.; Mokhtari, F.; Kazemian, E. Association of body composition in early pregnancy with gestational diabetes mellitus: A meta-analysis. PLoS ONE 2022, 17, e0271068. [Google Scholar] [CrossRef] [PubMed]
- Benevides, F.T.; Araujo Júnior, E.; Maia, C.S.C.; Montenegro, R.M., Jr.; Carvalho, F.H.C. Ultrasound evaluation of subcutaneous and visceral abdominal fat as a predictor of gestational diabetes mellitus: A systematic review. J. Matern. Fetal Neonatal Med. 2022, 35, 2216–2226. [Google Scholar] [CrossRef]
- Alves, J.G.; Souza, A.S.R.; Figueiroa, J.N.; de Araújo, C.A.L.; Guimarães, A.; Ray, J.G. Visceral Adipose Tissue Depth in Early Pregnancy and Gestational Diabetes Mellitus—A Cohort Study. Sci. Rep. 2020, 10, 2032. [Google Scholar] [CrossRef] [PubMed]
- Armellini, F.; Zamboni, M.; Rigo, L.; Bergamo-Andreis, I.A.; Robbi, R.; De Marchi, M.; Bosello, O. Sonography detection of small intra-abdominal fat variations. Int. J. Obes. 1991, 15, 847–852. [Google Scholar] [PubMed]
- Balani, J.; Hyer, S.L.; Shehata, H.; Mohareb, F. Visceral fat mass as a novel risk factor for predicting gestational diabetes in obese pregnant women. Obstet. Med. 2018, 11, 121–125. [Google Scholar] [CrossRef]
- D’Ambrosi, F.; Crovetto, F.; Colosi, E.; Fabietti, I.; Carbone, F.; Tassis, B.; Motta, S.; Bulfoni, A.; Fedele, L.; Rossi, G.; et al. Maternal Subcutaneous and Visceral Adipose Ultrasound Thickness in Women with Gestational Diabetes Mellitus at 24–28 Weeks’ Gestation. Fetal Diagn. Ther. 2018, 43, 143–147. [Google Scholar] [CrossRef]
- Aksoy, H.; Aksoy, Ü.; Yücel, B.; Saygi Özyurt, S.; Aydın, T.; Alparslan Babayiğit, M. Fetal anterior abdominal wall thickness may be an early ultrasonographic sign of gestational diabetes mellitus. J. Matern. Fetal Neonatal Med. 2016, 29, 2028–2032. [Google Scholar] [CrossRef]
- Gur, E.B.; Genc, M.; Eskicioglu, F.; Kurtulmus, S.; Guclu, S. Ultrasonographic visceral fat thickness measurement may be a good scan test for prediction of gestational diabetes mellitus. J. Matern. Fetal Neonatal Med. 2015, 28, 893–894. [Google Scholar] [CrossRef] [PubMed]
- Gur, E.B.; Ince, O.; Turan, G.A.; Karadeniz, M.; Tatar, S.; Celik, E.; Yalcin, M.; Guclu, S. Ultrasonographic visceral fat thickness in the first trimester can predict metabolic syndrome and gestational diabetes mellitus. Endocrine 2014, 47, 478–484. [Google Scholar] [CrossRef] [PubMed]
- Miehle, K.; Stepan, H.; Fasshauer, M. Leptin, adiponectin and other adipokines in gestational diabetes mellitus and pre-eclampsia. Clin. Endocrinol. 2012, 76, 2–11. [Google Scholar] [CrossRef] [PubMed]
- De Gennaro, G.; Palla, G.; Battini, L.; Simoncini, T.; Del Prato, S.; Bertolotto, A.; Bianchi, C. The role of adipokines in the pathogenesis of gestational diabetes mellitus. Gynecol. Endocrinol. 2019, 35, 737–751. [Google Scholar] [CrossRef] [PubMed]
- Valencia-Ortega, J.; González-Reynoso, R.; Ramos-Martínez, E.G.; Ferreira-Hermosillo, A.; Peña-Cano, M.I.; Morales-Ávila, E.; Saucedo, R. New Insights into Adipokines in Gestational Diabetes Mellitus. Int. J. Mol. Sci. 2022, 23, 6279. [Google Scholar] [CrossRef] [PubMed]
- Tangjittipokin, W.; Thanatummatis, B.; Wardati, F.; Narkdontri, T.; Teerawattanapong, N.; Boriboonhirunsarn, D. The genetic polymorphisms and levels of adipokines and adipocytokines that influence the risk of developing gestational diabetes mellitus in Thai pregnant women. Gene 2023, 860, 147228. [Google Scholar] [CrossRef] [PubMed]
- Alwash, S.M.; McIntyre, H.D.; Mamun, A. The association of general obesity, central obesity and visceral body fat with the risk of gestational diabetes mellitus: Evidence from a systematic review and meta-analysis. Obes. Res. Clin. Pract. 2021, 15, 425–430. [Google Scholar] [CrossRef]
- Rocha, A.D.S.; Bernardi, J.R.; Matos, S.; Kretzer, D.C.; Schöffel, A.C.; Goldani, M.Z.; de Azevedo Magalhães, J.A. Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery—A cohort study. PLoS ONE 2020, 15, e0232155. [Google Scholar] [CrossRef]
- Zhang, Y.Z.; Zhou, L.; Tian, L.; Li, X.; Zhang, G.; Qin, J.Y.; Zhang, D.D.; Fang, H. A mid-pregnancy risk prediction model for gestational diabetes mellitus based on the maternal status in combination with ultrasound and serological findings. Exp. Ther. Med. 2020, 20, 293–300. [Google Scholar] [CrossRef]
- Pontual, A.C.; Figueiroa, J.N.; De Souza, L.R.; Ray, J.G.; Alves, J.G. Visceral Adiposity in the First Half of Pregnancy in Association with Glucose, Lipid and Insulin Profiles in Later Pregnancy: A Cohort Study. Matern. Child Health J. 2016, 20, 1720–1725. [Google Scholar] [CrossRef]
- McCarthy, E.A.; Strauss, B.J.; Walker, S.P.; Permezel, M. Determination of maternal body composition in pregnancy and its relevance to perinatal outcomes. Obstet. Gynecol. Surv. 2004, 59, 731–742. [Google Scholar] [CrossRef]
- Metzger, B.E.; Lowe, L.P.; Dyer, A.R.; Trimble, E.R.; Chaovarindr, U.; Coustan, D.R.; Hadden, D.R.; McCance, D.R.; Hod, M.; McIntyre, H.D.; et al. Hyperglycemia and adverse pregnancy outcomes. N. Engl. J. Med. 2008, 358, 1991–2002. [Google Scholar] [CrossRef]
- Jatavan, P.; Luewan, S.; Sirilert, S.; Tongsong, T. Trends in the Prevalence of Diabetes Mellitus in Pregnancy during the Past Two Decades in Northern Thailand. Healthcare 2023, 11, 1315. [Google Scholar] [CrossRef]
- Benevides, F.T.; Araujo, E., Jr.; Maia, C.S.C.; Maia e Holanda Moura, S.B.; Montenegro, R.M., Jr.; Carvalho, F.H.C. Evaluation of ultrasound measurements of abdominal fat for the prediction of gestational diabetes in the first and second trimesters of pregnancy. J. Matern. Fetal Neonatal Med. 2022, 35, 9821–9829. [Google Scholar] [CrossRef]
- Luewan, S.; Bootchaingam, P.; Tongsong, T. Comparison of the Screening Tests for Gestational Diabetes Mellitus between “One-Step” and “Two-Step” Methods among Thai Pregnant Women. Obstet. Gynecol. Int. 2018, 2018, 1521794. [Google Scholar] [CrossRef]
Characteristics | GDM (N = 31) | Non-GDM (N = 108) | p-Value |
---|---|---|---|
Maternal | |||
| 32.4 ± 4.83 | 30.3 ± 5.10 | 0.046 * |
| 9 (29) | 40 (37) | 0.523 # |
| 60.9 ± 17.90 | 56.2 ± 10.13 | 0.063 * |
| 24.1 ± 5.77 | 22.3 ± 3.65 | 0.042 * |
| 2 (6.3) | 3 (2.8) | 0.318 # |
| 0 (0) | 1 (0.9) | 1.000 # |
| 2 (6.3) | 6 (5.5) | 1.000 # |
Obstetrics outcomes | |||
| 37.8 ± 1.89 | 38.5 ± 1.37 | 0.029 * |
| 2932 ± 402.2 | 3029 ± 402.3 | 0.240 * |
| 279 ± 196.2 | 317 ± 179.1 | 0.324 * |
Outcomes | GDM (N = 31) | Non-GDM (N = 108) | p-Value * |
---|---|---|---|
CRL at first scan (cm: mean ± SD) | 6.0 ± 0.91 | 5.9 ± 0.91 | 0.513 |
VAT at first scan (cm: mean ± SD) | 4.0 ± 1.09 | 3.8 ± 1.01 | 0.177 |
BPD at second scan (cm: mean ± SD) | 4.6 ± 0.27 | 4.6 ± 0.32 | 0.877 |
VAT at second scan (cm: mean ± SD) | 5.7 ± 1.19 | 5.4 ± 1.07 | 0.188 |
VAT difference (cm: mean ± SD) | 1.6 ± 0.91 | 1.6 ± 1.12 | 0.925 |
Risk Factors | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|
p-Value | Odds Ratio (95% CI) | p-Value | Odds Ratio (95% CI) | |
Age (year) | 0.049 | 0.92 (0.85–1.00) | 0.035 | 0.91 (0.82–0.99) |
Pre-pregnancy BMI (Kg/m2) | 0.048 | 0.91 (0.84–1.00) | 0.136 | 0.91 (0.80–1.03) |
VAT in the first trimester (cm) | 0.179 | 0.78 (0.54–1.12) | 0.728 | 1.10 (0.66–1.83) |
VAT in the second trimester (cm) | 0.188 | 0.78 (0.55–1.13) | 0.868 | 0.96 (0.60–1.54) |
VAT difference (cm) | 0.925 | 0.98 (0.68–1.42) | - | - |
Parity | 0.412 | 1.44 (0.60–3.43) | 0.152 | 0.49 (0.19–1.30) |
GDM in previous pregnancy | 0.360 | 0.42 (0.07–2.66) | 0.312 | 0.37 (0.05–2.55) |
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Detsrisuwan, J.; Luewan, S.; Sirichotiyakul, S.; Tongsong, T. Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus. J. Clin. Med. 2024, 13, 493. https://doi.org/10.3390/jcm13020493
Detsrisuwan J, Luewan S, Sirichotiyakul S, Tongsong T. Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus. Journal of Clinical Medicine. 2024; 13(2):493. https://doi.org/10.3390/jcm13020493
Chicago/Turabian StyleDetsrisuwan, Jirat, Suchaya Luewan, Supatra Sirichotiyakul, and Theera Tongsong. 2024. "Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus" Journal of Clinical Medicine 13, no. 2: 493. https://doi.org/10.3390/jcm13020493
APA StyleDetsrisuwan, J., Luewan, S., Sirichotiyakul, S., & Tongsong, T. (2024). Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus. Journal of Clinical Medicine, 13(2), 493. https://doi.org/10.3390/jcm13020493