Early-Pregnancy Metabolic Syndrome and Subsequent Incidence in Gestational Diabetes Mellitus in Arab Women.

Kaiser Wani,Iqbal Z Turkestani,Mona A Fouda,Naemah M Alshingetti,Nasser M Al-Daghri,Abdullah M Alnaami,Abdulrahman Al-Ajlan,Shaun Sabico,Majed S Alokail,Sara Al-Musharaf

doi:10.3389/fendo.2020.00098

Abstract

Introduction: This study aimed to investigate the association between components of metabolic syndrome (MetS) at first trimester and development of Gestational diabetes mellitus (GDM) in 498 Saudi pregnant women.Materials and Methods: Biochemical and anthropometric parameters were determined at the first trimester and MetS components were defined. Participants were screened for GDM at follow up according to International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The main outcome measures were development of GDM and GDM risk vs. MetS components at first trimester.Results: One hundred twenty three (24.7%) were diagnosed with GDM according to IADPSG criteria. GDM risk was significantly higher for participants with hypertriglyceridemia at 1st trimester even after adjusting for age, BMI and parity (OR: 1.82; CI: 1.1–3.7, p = 0.04). Furthermore, the odds of hyperglycemia at 1st trimester was significantly higher in GDM than in non-GDM participants even after adjustments (OR: 2.13, 95% CI: 1.1 to 4.3, p = 0.038). The receiver operating characteristic (ROC) for predicting GDM revealed an area under the curve (AUC) of 0.69 (95% CI: 0.64 to 0.74, p < 0.001) and 0.71 (95% CI: 0.65 to 0.77, p < 0.001) for first-trimester hyperglycemia and hypertriglyceridemia respectively.Conclusions: The incidence of GDM in Saudi pregnant women was strongly associated with hyperglycemia and hypertriglyceridemia at first trimester. These findings are of clinical importance, as an assessment of MetS in early pregnancy can identify women at higher risk of developing GDM.

Highlights

This study aimed to investigate the association between components of metabolic syndrome (MetS) at first trimester and development of Gestational diabetes mellitus (GDM) in 498 Saudi pregnant women
The rationale behind this is that the impairment in glucose regulation found in GDM is linked to the placental hormone-mediated insulin resistance which increases as pregnancy advances [7, 8]
Fasting glucose and 2 h oral glucose tolerance test (OGTT) values at second trimester were used to diagnose 123 (24.7 %) pregnant women as having GDM according to IADPSG criteria

Summary

Introduction

This study aimed to investigate the association between components of metabolic syndrome (MetS) at first trimester and development of Gestational diabetes mellitus (GDM) in 498 Saudi pregnant women. Glucose regulation normalizes immediately after delivery, studies suggest that women who had GDM are at an increased risk of progressing to type 2 diabetes mellitus (T2DM) and their infants are at a higher risk for childhood obesity [5, 6]. GDM screening, according to the recommendations given by the International Association of Diabetes and Pregnancy Study Group (IADPSG) is done anytime between the latter half to the end of the second trimester. The rationale behind this is that the impairment in glucose regulation found in GDM is linked to the placental hormone-mediated insulin resistance which increases as pregnancy advances [7, 8]. Researchers are looking at the possibility of identifying women at risk for GDM, in the early pregnancy in the first trimester [9]

Objectives

Methods

Results

Conclusion