Department of Obstetrics, The First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China.
Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
BMC Cardiovasc Disord. 2020 Apr 19;20(1):184. doi: 10.1186/s12872-020-01480-7.
Gestational diabetes mellitus (GDM) is the most common metabolic disorder that can occur during pregnancy and is associated with a long-term risk of both maternal and neonatal comorbidities. This study aimed to investigate the association between echocardiographic epicardial adipose tissue (EAT) and the risk for GDM during the early second trimester of pregnancy.
We recruited all singleton pregnancies between January 2014 and December 2018 at 16 weeks + 0 days to 19 weeks + 6 days. We then used generalized linear models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for EAT as a potential predictor for GDM. Receiver-operating-characteristic (ROC) analysis was then conducted to investigate the discriminative capacity of any individual maternal factor for the prediction of GDM.
In total, our study involved 314 pregnant women with GDM and 1832 pregnant women without GDM. Multivariate regression analysis revealed that EAT thickness (OR = 2.87; 95% CI: 2.49-3.31) was significantly associated with the presence of GDM (P < 0.001). Furthermore, EAT thickness was also significantly associated with a range of adverse outcomes in the GDM group, including large size for gestational age, neonatal hypoglycemia, admission to the neonatal intensive care unit, preterm delivery, and hyperbilirubinemia (P < 0.001). ROC analysis revealed that the area under the curve was 0.790 (95% CI: 0.768-0.812). When the cutoff value for EAT thickness was set to 5.49 mm, the sensitivity was 95.2% and the specificity was 50.5%.
Echocardiographic EAT thickness is positively and significantly associated with both the risk of GDM and adverse outcomes related to GDM. Echocardiographic EAT has the potential to predict GDM prior to actual clinical diagnosis.
妊娠糖尿病（GDM）是最常见的妊娠期间发生的代谢紊乱，与母婴长期合并症的风险相关。本研究旨在探讨妊娠中期早期超声心动图心外膜脂肪组织（EAT）与 GDM 风险之间的关系。
我们招募了 2014 年 1 月至 2018 年 12 月期间 16 周+0 天至 19 周+6 天的所有单胎妊娠。然后，我们使用广义线性模型计算 EAT 作为 GDM 潜在预测因子的优势比（OR）和 95%置信区间（CI）。然后进行接收者操作特征（ROC）分析，以研究任何个体母体因素对 GDM 预测的鉴别能力。
共有 314 例 GDM 孕妇和 1832 例非 GDM 孕妇参与了我们的研究。多变量回归分析显示，EAT 厚度（OR=2.87；95%CI：2.49-3.31）与 GDM 的发生显著相关（P<0.001）。此外，EAT 厚度与 GDM 组的一系列不良结局也显著相关，包括胎儿大小与胎龄不符、新生儿低血糖、新生儿重症监护病房入院、早产和高胆红素血症（P<0.001）。ROC 分析显示曲线下面积为 0.790（95%CI：0.768-0.812）。当 EAT 厚度的截断值设定为 5.49mm 时，灵敏度为 95.2%，特异性为 50.5%。
超声心动图 EAT 厚度与 GDM 风险和 GDM 相关不良结局均呈正相关且显著相关。超声心动图 EAT 有可能在实际临床诊断前预测 GDM。
