Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
PLoS One. 2022 Aug 1;17(8):e0272253. doi: 10.1371/journal.pone.0272253. eCollection 2022.
This study examined the association between height and the risk of Gestational Diabetes Mellitus (GDM), and whether this association was mediated or moderated by early pregnancy body mass index (BMI) and gestational weight gain (GWG) that are known independent risk factors for GDM. Data of a retrospective cohort of pregnant women (N = 1,945) were extracted from antenatal clinic cards. The cut-off values of height in relation to risk of GDM were identified using receiver operating characteristic analysis and four categories of height were derived: < 150 cm, 150-155 cm, 156-160 cm, and > 160cm. Mediation analysis was performed using the Preacher and Hayes bootstrapping method while the moderation effect was tested with multiple regression analysis with interaction terms. Although there was no mediation effect of BMI and GWG on the association between height and risk of GDM, both factors moderated this association with a significant association between shorter height and risk of GDM was observed in overweight / obese women (height < 150 cm: AOR = 1.41, 95% CI = 1.03-2.44; height 156-160 cm: AOR = 1.48, 95% CI = 1.03-2.14). Overweight / obese women with height < 150 cm and excessive GWG at the end of the second trimester (AOR = 2.25, 95% CI = 1.45-4.17) had significantly higher risk of GDM than those without these factors. Short stature (< 150 cm) was significantly associated with GDM risk among OW/OB women with excessive gestational weight gain at the end of second trimester. This finding underscores the importance of maintaining a healthy BMI during reproductive age and gaining weight in recommended range during pregnancy.
本研究旨在探讨身高与妊娠期糖尿病（GDM）风险之间的关联，以及该关联是否受到早孕期体重指数（BMI）和妊娠体重增加（GWG）的中介或调节作用的影响，因为这些因素是 GDM 的独立危险因素。从产前门诊卡中提取了一个回顾性队列孕妇的数据（N=1945）。使用受试者工作特征分析确定了与 GDM 风险相关的身高临界值，并得出了 4 个身高类别：<150cm、150-155cm、156-160cm 和>160cm。使用 Preacher 和 Hayes bootstrap 方法进行中介分析，使用带有交互项的多元回归分析测试调节效应。尽管 BMI 和 GWG 对身高与 GDM 风险之间的关联没有中介作用，但这两个因素都调节了这种关联，在超重/肥胖女性中，身高较矮与 GDM 风险之间存在显著关联（身高<150cm：AOR=1.41，95%CI=1.03-2.44；身高 156-160cm：AOR=1.48，95%CI=1.03-2.14）。身高<150cm 且孕晚期 GWG 过多的超重/肥胖女性（AOR=2.25，95%CI=1.45-4.17）发生 GDM 的风险明显高于没有这些因素的女性。在孕晚期 GWG 过多的超重/肥胖女性中，矮小身材（<150cm）与 GDM 风险显著相关。这一发现强调了在生育年龄保持健康 BMI 和在孕期内按建议范围增加体重的重要性。
