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Khobrani FM, alzahrani AM, Binmahfoodh DS, Hemedy RA, Abbas SI. Risk factors and diagnostic performance of predictors as a screening technique for gestational diabetes mellitus: a retrospective cross-sectional study. Ann Med Surg (Lond) 2024; 86:4384-4388. [PMID: 39118718 PMCID: PMC11305797 DOI: 10.1097/ms9.0000000000002247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 05/27/2024] [Indexed: 08/10/2024] Open
Abstract
Background Gestational diabetes mellitus (GDM) is a condition that can have negative impacts on both mother and baby. Detecting GDM early is crucial, and fasting plasma glucose (FPG) has been suggested as a possible screening method. This retrospective cross-sectional study aims to investigate potential risk factors and complications associated with GDM. Additionally, it aims to establish the diagnostic performance of predictive factors as a screening method for GDM. Methods Data were collected from the medical records of 247 pregnant women who visited outpatient Obstetrics clinics between 2021 and 2022. The study investigated potential risk factors and complications associated with GDM, including impaired fasting glucose/impaired glucose tolerance (IFG/IGT), family history of diabetes mellitus (DM), and medical conditions. Moreover, the study evaluated the diagnostic performance of potential predictors as screening techniques for GDM. Results The study found that IFG/IGT (P<0.001), a history of GDM (P<0.001), and a family history of DM (P=0.022) were significant factors associated with GDM. Healthy individuals had a lower risk of developing GDM (P<0.001). No significant correlation was found between GDM and macrosomia, hypertension, polycystic ovarian syndrome, or other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not significant. Conclusion In conclusion, this study found that IFG/IGT and a past history of GDM were significantly associated with GDM. Additionally, a family history of diabetes increased the likelihood of developing GDM, while no significant association was found between GDM and other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not statistically significant.
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Affiliation(s)
- Fatimah Mudaia Khobrani
- King Abdullah International Medical Research Center, Riyadh
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Abdullah Mohammad alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center, Riyadh
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Dina Saleh Binmahfoodh
- King Abdullah International Medical Research Center, Riyadh
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Rawan Abdullah Hemedy
- King Abdullah International Medical Research Center, Riyadh
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Salwa Ibrahim Abbas
- King Abdullah International Medical Research Center, Riyadh
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
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Duo Y, Song S, Qiao X, Zhang Y, Xu J, Zhang J, Peng Z, Chen Y, Nie X, Sun Q, Yang X, Wang A, Sun W, Fu Y, Dong Y, Lu Z, Yuan T, Zhao W. A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Pregnant Chinese Women. Diabetes Ther 2023; 14:2143-2157. [PMID: 37843770 PMCID: PMC10597926 DOI: 10.1007/s13300-023-01480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION This study aimed to develop a simplified screening model to identify pregnant Chinese women at risk of gestational diabetes mellitus (GDM) in the first trimester. METHODS This prospective study included 1289 pregnant women in their first trimester (6-12 weeks of gestation) with clinical parameters and laboratory data. Logistic regression was performed to extract coefficients and select predictors. The performance of the prediction model was assessed in terms of discrimination and calibration. Internal validation was performed through bootstrapping (1000 random samples). RESULTS The prevalence of GDM in our study cohort was 21.1%. Maternal age, prepregnancy body mass index (BMI), a family history of diabetes, fasting blood glucose levels, the alanine transaminase to aspartate aminotransferase ratio (ALT/AST), and the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were selected for inclusion in the prediction model. The Hosmer-Lemeshow goodness-of-fit test showed good consistency between prediction and actual observation, and bootstrapping indicated good internal performance. The area under the receiver operating characteristic curve (ROC-AUC) of the multivariate logistic regression model and the simplified clinical screening model was 0.825 (95% confidence interval [CI] 0.797-0.853, P < 0.001) and 0.784 (95% CI 0.750-0.818, P < 0.001), respectively. The performance of our prediction model was superior to that of three other published models. CONCLUSION We developed a simplified clinical screening model for predicting the risk of GDM in pregnant Chinese women. The model provides a feasible and convenient protocol to identify women at high risk of GDM in early pregnancy. Further validations are needed to evaluate the performance of the model in other populations. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03246295.
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Affiliation(s)
- Yanbei Duo
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Shuoning Song
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Xiaolin Qiao
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Yuemei Zhang
- Department of Obstetrics, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Jiyu Xu
- Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Jing Zhang
- Department of Laboratory, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Zhenyao Peng
- Department of Dean's Office, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Yan Chen
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Xiaorui Nie
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Qiujin Sun
- Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Xianchun Yang
- Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China
| | - Ailing Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Wei Sun
- Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Yong Fu
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Yingyue Dong
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Zechun Lu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Tao Yuan
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
| | - Weigang Zhao
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
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Najafi F, Hasani J, Izadi N, Hashemi-Nazari SS, Namvar Z, Shamsi H, Erfanpoor S. Risk of gestational diabetes mellitus by pre-pregnancy body mass index: A systematic review and meta-analysis. Diabetes Metab Syndr 2021; 15:102181. [PMID: 34214900 DOI: 10.1016/j.dsx.2021.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/13/2021] [Accepted: 06/15/2021] [Indexed: 01/01/2023]
Abstract
Gestational diabetes mellitus (GDM) is serious health challenges. This study aimed at determining the risk of GDM among pregnant women by pre-pregnancy BMI. Five electronic databases including Medline (PubMed), Scopus, Embase, Web of Science and Google Scholar were searched for literature published form 2015 to January 1, 2021. The pooled estimate risk of GDM among pregnant women was 16.8% (95% CI: 15.3-18.4). The risk of GDM in underweight/normal group and overweight/obese group were 10.7% (95% CI: 9.1-12.4) and 23% (95% CI: 20.2-25.9), respectively. The risk of GDM is high among overweight/obese pregnant women.
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Affiliation(s)
- Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalil Hasani
- Kashmar School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Izadi
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed-Saeed Hashemi-Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Namvar
- Student Research Committee, Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasan Shamsi
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Erfanpoor
- Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran
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Bojnordi TE, Hantoushzadeh S, Sabzevary M, Heidari Z. A case-control study to predict the risk of gestational diabetes mellitus by initial fasting blood sugar or past gestational history. Int J Reprod Biomed 2021; 19:381-390. [PMID: 33997597 PMCID: PMC8106815 DOI: 10.18502/ijrm.v19i4.9064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/11/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) deserves proper prevention, diagnosis, and management due to healthcare implications from both maternal and fetal concerns. OBJECTIVE To evaluate the rate and investigate the risk factors for developing GDM. MATERIALS AND METHODS In this case-control, universal screening for GDM between 24 and 28 wk of gestation was performed in 613 pregnant women attending a prenatal clinic in Tehran who were followed-up until delivery between March 2017 to March 2018. Of the 613 women, 143 had GDM and 470 had normal glucose tolerance test as the primary diagnosis. Some GDM risk factors were compared in two groups. RESULTS Impaired glucose tolerance test was detected in 143 (23.3%) patients. Prevalence of GDM was higher in the first-trimester fasting blood sugar (FBS) > 90 qmg/dl group (p < 0.001). Comparison of the GDM and the normal glucose tolerance test groups demonstrated significant differences in maternal age, first-trimester FBS, third-trimester vitamin D level, maternal platelet count, maternal body mass index (BMI) (before 12 wk of gestation), weight gain during pregnancy, and the history of gestational complications in previous pregnancy (p < 0.01). In logistic regression, GDM was independently associated with older maternal age, higher first-trimester FBS, the history of gestational complications in previous pregnancy, lower third-trimester vitamin D level, and higher maternal platelet count (p < 0.01). CONCLUSION Both patients with higher initial FBS and the history of gestational complications in previous pregnancy should be considered high risk for GDM and screened earlier.
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Affiliation(s)
- Tahmineh Ezazi Bojnordi
- Department of Obstetrics and Gynecology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Hantoushzadeh
- Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masomeh Sabzevary
- Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Department of Histology, Genetic of Non-communicable Diseases Research Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Wei YM, Liu XY, Shou C, Liu XH, Meng WY, Wang ZL, Wang YF, Wang YQ, Cai ZY, Shang LX, Sun Y, Yang HX. Value of fasting plasma glucose to screen gestational diabetes mellitus before the 24th gestational week in women with different pre-pregnancy body mass index. Chin Med J (Engl) 2019; 132:883-888. [PMID: 30958429 PMCID: PMC6595770 DOI: 10.1097/cm9.0000000000000158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test (OGTT). It is difficult to predict GDM before 24th gestational week because fast plasma glucose (FPG) decreases as the gestational age increases. It is controversial that if FPG ≥5.1 mmol/L before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index (BMI). METHODS This was a multi-region retrospective cohort study in China. Women who had a singleton live birth between June 20, 2013 and November 30, 2014, resided in Beijing, Guangzhou and Chengdu, and received prenatal care in 21 selected hospitals, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight, BMI < 18.5 kg/m), Group B (normal, BMI 18.5-23.9 kg/m), Group C (overweight, BMI 24.0-27.9 kg/m) and Group D (obesity, BMI ≥28.0 kg/m). The trend of FPG before 24th week of gestation was described, and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported. Differences in the means between groups were evaluated using independent sample t-test and analysis of variance. Pearson Chi-square test was used for categorical variables. RESULTS The prevalence of GDM was 20.0% (6806/34,087) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. FPG was higher in women with higher pre-pregnancy BMI. FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM. The incidence of GDM in women with FPG ≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥5.10 mmol/L and pre-pregnancy BMI <24.0 kg/m (78.5% [62/79] vs. 52.9% [64/121], χ = 13.425, P < 0.001). CONCLUSIONS FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
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Affiliation(s)
- Yu-Mei Wei
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Xin-Yue Liu
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
| | - Chong Shou
- Hallmark Health System, Medford, MA 02155, USA
| | - Xing-Hui Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, China
| | - Wen-Ying Meng
- Department of Obstetrics and Gynecology, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101101, China
| | - Zi-Lian Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Yun-Feng Wang
- Department of Obstetrics and Gynecology, Beijing Miyun Hospital, Beijing 101500, China
| | - Yong-Qing Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Zhen-Yu Cai
- Department of Obstetrics and Gynecology, Center Hospital of Aviation Industry, Beijing 100012, China
| | - Li-Xin Shang
- Department of Obstetrics and Gynecology, General Hospital of Beijing Military Region, Beijing 100700, China
| | - Ying Sun
- Department of Obstetrics and Gynecology, Navy General Hospital, Beijing 100000, China
| | - Hui-Xia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
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Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, Wan Sulaiman WA, Suppiah S, Mohamed MH, Veettil SK. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18:494. [PMID: 30547769 PMCID: PMC6295048 DOI: 10.1186/s12884-018-2131-4] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 11/30/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. METHODS We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). RESULTS Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9-12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35-13.23); macrosomia (OR 4.41, 95% CI 3.09-6.31); and congenital anomalies (OR 4.25, 95% CI 1.52-11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81-3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19-4.68); family history of diabetes (OR 2.77, 2.22-3.47); history of stillbirth (OR 2.39, 95% CI 1.68-3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72-3.17); history of abortion (OR 2.25, 95% CI 1.54-3.29); age ≥ 25 (OR 2.17, 95% CI 1.96-2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24-1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21-3.07). CONCLUSION We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy. TRIAL REGISTRATION PROSPERO (2017: CRD42017070104 ).
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Affiliation(s)
- Kai Wei Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, University of Malaya Center for Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Fan Kee Hoo
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Yook Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 47500 Bandar Sunway, Selangor Malaysia
| | - Wan Aliaa Wan Sulaiman
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Subapriya Suppiah
- Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Mohd Hazmi Mohamed
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Sajesh K. Veettil
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
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Hashemi-Nazari SS, Najafi F, Rahimi MA, Izadi N, Heydarpour F, Forooghirad H. Estimation of gestational diabetes mellitus and dose-response association of BMI with the occurrence of diabetes mellitus in pregnant women of the west of Iran. Health Care Women Int 2018; 41:121-130. [PMID: 30433854 DOI: 10.1080/07399332.2018.1521812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The authors aim to investigate the GDM and the dose-response association of BMI with it in pregnant women in Kermanshah, Iran. During the 2015-2016 year, the 1010 pregnant women were studied. The restricted cubic spline method was used to evaluate the relationship between BMI and GDM. The risk of GDM was 10.1%. The incidence rate ratio for GDM indicates a non-significant protective effect and, then a significant risk for GDM occurrence along with BMI. BMI can be used as a predictive factor. A healthy diet and recommended levels of physical activity are suggested to prevent overweight and obesity and subsequent GDM.
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Affiliation(s)
- Seyed-Saeed Hashemi-Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehr-Ali Rahimi
- Department of Internal Medicine, Diabetes Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Neda Izadi
- Student Research Committee, Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Heydarpour
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hosna Forooghirad
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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Huang Y, Chen X, Chen X, Feng Y, Guo H, Li S, Dai T, Jiang R, Zhang X, Fang C, Hu J. Angiopoietin-like protein 8 in early pregnancy improves the prediction of gestational diabetes. Diabetologia 2018; 61:574-580. [PMID: 29167926 DOI: 10.1007/s00125-017-4505-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/16/2017] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Screening high-risk individuals for gestational diabetes mellitus (GDM) in early pregnancy conventionally relies on established maternal risk factors; however, the sensitivity and specificity of these factors are not satisfactory. The present study aimed to determine whether the concentration of angiopoietin-like protein 8 (ANGPTL8), either alone or combined with other risk factors in early pregnancy, could be used to predict subsequent GDM. METHODS From August 2015 to January 2016, 474 women receiving prenatal care at around 12-16 weeks of gestation were recruited into the study. ANGPTL8 levels were measured at the first prenatal visit. All the participants received a 75 g OGTT during weeks 24-28 of gestation. RESULTS ANGPTL8 levels in early pregnancy were considerably higher in women who developed GDM than those who maintained normal glucose tolerance (2822 ± 938 vs 2120 ± 1118 pg/ml, respectively; p < 0.0001). Multivariable logistic regression revealed that ANGPTL8 levels were significantly associated with risk of GDM independent of conventional risk factors. In addition, women in the highest quartile of ANGPTL8 concentration had an 8.75-fold higher risk of developing GDM compared with women in the lowest quartile (OR8.75, 95%CI 2.43, 31.58). More importantly, incorporating ANGPTL8 into the conventional prediction model significantly increased the AUC for prediction of GDM (0.772vs 0.725; p = 0.019). CONCLUSIONS Our study suggests that ANGPTL8 levels in early pregnancy are significantly and independently associated with risk of GDM at 24-28 weeks of gestation. Combining ANGPTL8 levels with conventional risk factors could thus improve the prediction of GDM.
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Affiliation(s)
- Yun Huang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Xin Chen
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Soochow University, Jiangsu, People's Republic of China
| | - Xiaohong Chen
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Yu Feng
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Heming Guo
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Sicheng Li
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Ting Dai
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Rong Jiang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Xiaoyan Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Chen Fang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China.
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, People's Republic of China.
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