Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey.
Echocardiography. 2022 Aug;39(8):1082-1088. doi: 10.1111/echo.15416. Epub 2022 Jul 9.
To study the value of fetal epicardial fat thickness (EFT) in gestational diabetes mellitus in the third trimester of pregnancy and its relationship with clinical parameters and perinatal outcomes.
A total of 80 participants, including 40 with diagnosed GDM and 40 healthy pregnant women, were included in the study. Demographic data were obtained from medical records. Sonographic examinations were performed, such as amniotic fluid value, fetal biometric measurements, and Doppler parameters of the umbilical artery. Fetal EFT values were measured at the free wall of the right ventricle using a reference line with echocardiographic methods. Correlation tests were performed to evaluate the relationship between fetal EFT and clinical and perinatal parameters. p < .05 were interpreted as statistically significant.
The fetal EFT value was statistically higher in the GDM group than in the control group (p: .000). Spearman and Pearson correlation tests revealed statistically significant but weak positive correlations between fetal EFT value, 1-h 100-g OGTT, birth weight, and BMI (r: .198, p: .047; r: .395, p: .012; r: .360, p: .042, respectively). The optimal fetal EFT threshold for predicting GDM disease was found as 1.55 mm, with a specificity of 74.4% and sensitivity of 75.0%. Statistically significant differences between the two groups in umbilical artery Doppler resistance index (RI), pulsatility index (PI), and systolic/diastolic ratio (S/D) were not found (p: .337; p: .503; p: .155;). BMI and amniotic fluid volume were higher in the GDM group compared to the control group (p: .009; p < .01).
This study demonstrated that increased fetal EFT may occur as a reflection of changes in glucose metabolism in intrauterine life. Future studies with larger series, including the study of neonatal metabolic parameters, will contribute to the understanding of the importance of fetal EFT in determining the metabolic status of the fetus.
研究胎儿心外膜脂肪厚度（EFT）在妊娠晚期妊娠期糖尿病（GDM）中的价值及其与临床参数和围产结局的关系。
本研究纳入了 80 名参与者，包括 40 名确诊为 GDM 的孕妇和 40 名健康孕妇。从病历中获取人口统计学数据。进行超声检查，如羊水值、胎儿生物测量和脐动脉多普勒参数。使用超声心动图方法的参考线测量右心室游离壁的胎儿 EFT 值。采用相关性检验评估胎儿 EFT 与临床和围产参数的关系。p<.05 表示有统计学意义。
GDM 组胎儿 EFT 值明显高于对照组（p：.000）。Spearman 和 Pearson 相关性检验显示，胎儿 EFT 值与 1h 100gOGTT、出生体重和 BMI 之间存在统计学上显著但较弱的正相关（r：.198，p：.047；r：.395，p：.012；r：.360，p：.042）。预测 GDM 疾病的最佳胎儿 EFT 阈值为 1.55mm，特异性为 74.4%，敏感性为 75.0%。两组间脐动脉多普勒阻力指数（RI）、搏动指数（PI）和收缩/舒张比（S/D）无统计学差异（p：.337；p：.503；p：.155）。GDM 组 BMI 和羊水体积均高于对照组（p：.009；p<.01）。
本研究表明，胎儿 EFT 的增加可能是宫内生活中葡萄糖代谢变化的反映。未来更大系列的研究，包括新生儿代谢参数的研究，将有助于了解胎儿 EFT 在确定胎儿代谢状态方面的重要性。
