Overweight and obesity are associated with clustering of metabolic risk factors in early pregnancy and the risk of GDM.

I-Weng Yen,Yi-Yun Tai,Hung-Yuan Li,Jung-Nan Wei,Szu-Chi Chen,Kang-Chih Fan,Chien-Nan Lee,Chih-Yao Hsu,Shin-Yu Lin,Ming-Wei Lin,Kuan-Yu Chen,Chia-Hung Lin,Lee-Ming Chuang,Chun-Heng Kuo,Frank T Spradley

doi:10.1371/journal.pone.0225978

Abstract

AimOverweight and obesity are important risk factors of gestational diabetes mellitus (GDM). Clustering of metabolic risk factors in early pregnancy may be a potential pathogenesis between the link of overweight/obesity and GDM. Since it remains unexplored, we investigated if overweight and obesity are associated with clustering of metabolic risk factors in early pregnancy and the risk of GDM in this cohort study.MethodsTotal 527 women who visited National Taiwan University Hospital for prenatal care in between November 2013 to April 2018 were enrolled. Risk factors of GDM in the first prenatal visit (FPV) were recorded. Overweight/obesity was defined if body mass index ≥24 kg/m2. GDM was diagnosed from the result of a 75g oral glucose tolerance test in 24–28 gestational weeks.ResultsOverweight/obesity was associated with clustering of metabolic risk factors of GDM, including high fasting plasma glucose, high HbA1c, insulin resistance, high plasma triglyceride and elevated blood pressure in FPV (p<0.05). There was a positive relationship between the number of metabolic risk factors and the incidence of GDM (p <0.05). The odds ratios of HbA1c and diastolic blood pressure were higher in overweight/obese women, compared with those in normal-weight women.ConclusionsOverweight/obesity is associated with clustering of metabolic risk factors in early pregnancy, which is correlated with higher risk of GDM. Our findings suggest that metabolic risk factors during early pregnancy should be evaluated in overweight/obese women.

Highlights

Gestational diabetes mellitus (GDM) is defined when carbohydrate intolerance is developed or recognized during pregnancy for the first time [1]
Overweight/obesity was associated with clustering of metabolic risk factors of GDM, including high fasting plasma glucose, high hemoglobin A1c (HbA1c), insulin resistance, high plasma triglyceride and elevated blood pressure in first prenatal visit (FPV) (p
Overweight/obesity is associated with clustering of metabolic risk factors in early pregnancy, which is correlated with higher risk of GDM

Summary

Introduction

Gestational diabetes mellitus (GDM) is defined when carbohydrate intolerance is developed or recognized during pregnancy for the first time [1]. GDM results in increased risk of adverse pregnancy outcomes, including macrosomia, premature birth, hypoglycemia at birth, neonatal jaundice and congenital anomalies [3]. It is associated with a higher incidence of type 2 diabetes after delivery [4]. In non-pregnant status, metabolic abnormalities such as hypertension, central obesity, insulin resistance and atherogenic dyslipidemia tend to cluster. Clustering of these metabolic abnormalities is associated with the development of type 2 diabetes mellitus in the future [9]. There is no report investigating the relationship among obesity, clustering of metabolic risk factors and GDM in early pregnancy

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Conclusion