Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2183765. doi: 10.1080/14767058.2023.2183765.
To investigate the relationship between general and central obesity in the first trimester of pregnancy and gestational diabetes and its predicted value.
We recruited 813 women who registered at 6-12 weeks of gestation. Anthropometric measurements were done at the first antenatal visit. At 24-28 weeks of pregnancy, gestational diabetes was diagnosed using the 75 g oral glucose tolerance test. Binary logistic regression was used to determine odds ratios and 95% confidence intervals. The receiver-operating characteristic curve was used to evaluate the ability of obesity indices to predict the risk of gestational diabetes.
Odds ratios (95% confidence intervals) of gestational diabetes across increasing quartiles of waist-to-hip ratio were 1.00, 1.54 (0.65-3.66), 2.63 (1.18-5.85), and 4.96 (2.27-10.85), respectively ( < .001), while those for waist-to-height ratio were 1.00, 1.21 (0.47-3.08), 2.99 (1.26-7.10), and 4.01 (1.57-10.19), respectively ( < .001). Areas under the curve for general and central obesity were similar. However, the area under the curve of body mass index combined with the waist-to-hip ratio was the biggest.
Higher waist-to-hip ratio and waist-to-height ratio in the first trimester of pregnancy are associated with increased risks of gestational diabetes in Chinese women. The combination of body mass index and waist-to-hip ratio in the first trimester of pregnancy is a good predictor for gestational diabetes.
探讨妊娠早期全身肥胖和中心性肥胖与妊娠期糖尿病及其预测值的关系。
我们招募了 813 名在妊娠 6-12 周时登记的女性。在第一次产前检查时进行人体测量。在妊娠 24-28 周时，使用 75g 口服葡萄糖耐量试验诊断妊娠期糖尿病。使用二项逻辑回归确定比值比和 95%置信区间。使用受试者工作特征曲线评估肥胖指数预测妊娠期糖尿病风险的能力。
按腰围臀围比四分位递增，妊娠期糖尿病的比值比（95%置信区间）分别为 1.00、1.54（0.65-3.66）、2.63（1.18-5.85）和 4.96（2.27-10.85）（ < 0.001），而腰围身高比的比值比分别为 1.00、1.21（0.47-3.08）、2.99（1.26-7.10）和 4.01（1.57-10.19）（ < 0.001）。全身肥胖和中心性肥胖的曲线下面积相似。然而，体质量指数结合腰围臀围比的曲线下面积最大。
妊娠早期较高的腰围臀围比和腰围身高比与中国女性妊娠期糖尿病风险增加相关。妊娠早期体质量指数与腰围臀围比的结合是预测妊娠期糖尿病的良好指标。
