Gur Esra Bahar, Ince Ozlem, Turan Guluzar Arzu, Karadeniz Muammer, Tatar Sumeyra, Celik Esin, Yalcin Murat, Guclu Serkan
Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Sanayi St. No:7, 35100, Bornova, Izmir, Turkey,
Endocrine. 2014 Nov;47(2):478-84. doi: 10.1007/s12020-013-0154-1. Epub 2014 Jan 23.
The aim of this study is to evaluate whether ultrasonographic visceral fat thickness measurement in the early gestational period is useful for predicting the development of gestational diabetes mellitus (GDM) and metabolic syndrome (MS). The visceral fat thickness and subcutaneous fat thickness were measured via ultrasound at the first prenatal visit. The correlation between visceral and subcutaneous fat thickness and MS parameters, such as dyslipidemia, hypertension, and insulin resistance, was assessed. We also compared the use of visceral fat thickness measurement with body mass index (BMI) and waist circumference (WC) measurements for predicting the development of GDM. The subcutaneous fat thickness was found to be similar in the normal glucose metabolism and GDM groups at the first visit, whereas the visceral fat thickness was found to be considerably higher in the GDM groups (p = 0.04). The visceral fat thickness in the early stage of the gestation was correlated with hyperglycemia, dyslipidemia, high diastolic blood pressure, and insulin resistance. In contrast to subcutaneous fat thickness, BMI, and WC, only the visceral fat thickness was correlated with insulin resistance. The subcutaneous and visceral fat thicknesses at the first visit were significantly higher in the MS group (p = 0.02). There was a good correlation between visceral and subcutaneous fat thicknesses (r = 0.492, p < 0.001); however, there were poor correlations between visceral fat thickness and BMI and WC (r = 0.338, p = 0.01; r = 0.312, p = 0.02). The visceral fat thickness seemed to be a more sensitive predictor of GDM than WC and BMI. The optimal cutoff points for predicting GDM were visceral fat thickness 19.5 mm [area under curve (AUC) = 0.66, p = 0.043], WC 103.5 cm (AUC = 0.64, p = 0.079), and BMI 34.5 (AUC = 0.64, p = 0.069). Ultrasonographic visceral fat thickness measurement in the early period of gestation may be an easy, safe, and cost-effective scan test for predicting the development of metabolic diseases and GDM.
本研究的目的是评估孕早期超声测量内脏脂肪厚度是否有助于预测妊娠期糖尿病(GDM)和代谢综合征(MS)的发生。在首次产前检查时通过超声测量内脏脂肪厚度和皮下脂肪厚度。评估内脏和皮下脂肪厚度与MS参数(如血脂异常、高血压和胰岛素抵抗)之间的相关性。我们还比较了使用内脏脂肪厚度测量与体重指数(BMI)和腰围(WC)测量来预测GDM发生的情况。发现首次就诊时正常糖代谢组和GDM组的皮下脂肪厚度相似,而GDM组的内脏脂肪厚度明显更高(p = 0.04)。妊娠早期的内脏脂肪厚度与高血糖、血脂异常、高舒张压和胰岛素抵抗相关。与皮下脂肪厚度、BMI和WC不同,只有内脏脂肪厚度与胰岛素抵抗相关。MS组首次就诊时的皮下和内脏脂肪厚度显著更高(p = 0.02)。内脏和皮下脂肪厚度之间存在良好的相关性(r = 0.492,p < 0.001);然而,内脏脂肪厚度与BMI和WC之间的相关性较差(r = 0.338,p = 0.01;r = 0.312,p = 0.02)。内脏脂肪厚度似乎是比WC和BMI更敏感的GDM预测指标。预测GDM的最佳切点为内脏脂肪厚度19.5 mm [曲线下面积(AUC)= 0.66,p = 0.043]、WC 103.5 cm(AUC = 0.64,p = 0.079)和BMI 34.5(AUC = 0.64,p = 0.069)。孕早期超声测量内脏脂肪厚度可能是一种用于预测代谢疾病和GDM发生的简单、安全且经济有效的扫描检查。