Predictive Value of Homeostasis Model Assessment of Insulin Resistance, Visceral Fat Index, and Prepregnancy Body Mass Index in Gestational Metabolic Syndrome.

Laiping Zhao,Lichun Huang

doi:10.1155/2021/6709725

Abstract

Objective To explore the diagnostic value of homeostasis model assessment of insulin resistance (HOMA-IR), visceral fat index (VAI), and prepregnancy body mass index (BMI) in gestational metabolic syndrome (GMS). Methods From December 2019 to March 2021,122 GMS high-risk pregnant women who received routine antenatal clinic visits and planned to give birth in our hospital were selected as the research objects. Pregnant women were divided into the GMS group (n = 79) and the control group (n = 43) according to GMS diagnostic criteria during the gestation period of 32–36 weeks. The general information such as age and gestational week of pregnant women as well as HOMA-IR, VAI, and BMI before pregnancy were compared between the two groups. The glucose and lipid metabolism indexes of pregnant women in two groups were analyzed, the detection rates of HOMA-IR, VAI, and prepregnancy BMI in GMS between the two groups were compared. Logistic regression was used to analyze the risk factors for GMS in pregnant women, and receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of HOMA-IR, VAI, prepregnancy BMI, and the combination of the three for GMS. Results The body weight, systolic blood pressure, and diastolic blood pressure of the GMS group were higher than those of the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in age, gestational week, and height between the two groups (P > 0.05). The levels of FPG, FINS, TC, TG, LDL-C, and FFA in the GMS group were higher than the control group, the level of HDL-C in the GMS group was lower than the control group, and the difference was statistically significant (P < 0.05). The levels of HOMA-IR, VAI, and prepregnancy BMI in the GMS group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The positive detection rates of HOMA-IR, VAI, and prepregnancy BMI in the GMS group were 83.54%, 86.07%, and 81.01%, respectively. There was no significant difference in the positive detection rates of HOMA-IR, VAI, and prepregnancy BMI between the two groups (P > 0.05). High levels of HOMA-IR, VAI, and prepregnancy BMI were risk factors for GMS in pregnant women (P < 0.05). ROC curve showed area under the curve for HOMA-IR was 0.810, area under the curve for VAI was 0.771, and area under the curve for prepregnancy BMI was 0.749. The AUC for the combination of HOMA-IR, VAI, and prepregnancy BMI was 0.918. Conclusion HOMA-IR, VAI, and prepregnancy BMI in GMS have a high detection rate and certain diagnostic value, and the combination of the three has higher clinical value.

Highlights

Gestational metabolic syndrome (GMS) is a group of syndromes occurring during pregnancy, which is mainly characterized by central obesity, insulin resistance (IR), abnormal metabolism of blood glucose and lipid, and other metabolic diseases [1, 2]
Compared with single indexes such as waist circumference and weight, visceral obesity index (VAI) can be used to evaluate visceral fat dysfunction and cardiovascular risk factors. It can more accurately reflect the visceral fat content of patients and effectively predict the occurrence of GMS [8]. e prepregnancy body mass index (BMI) can be used to measure the nutritional status of the mother before pregnancy. e increase in prepregnancy BMI will increase the risk of GMS, which will lead to a significant increase in the incidence of neonatal weight abnormalities and adverse pregnancy outcomes [9, 10]
Fasting venous blood was collected in the morning, and the automatic biochemical analyzer was used to detect fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDLC), free fatty acid (FFA), and other biochemical indicators

Summary

Introduction

Gestational metabolic syndrome (GMS) is a group of syndromes occurring during pregnancy, which is mainly characterized by central obesity, insulin resistance (IR), abnormal metabolism of blood glucose and lipid, and other metabolic diseases [1, 2]. In order to meet the growth needs of the fetus, pregnant women will suffer from physiologically stressful IR, but excessive IR will lead to metabolic abnormalities of blood glucose and lipid, leading to the occurrence of GMS and increasing the risk of poor delivery outcome of pregnant women and poor prognosis of neonates [6, 7]. Compared with single indexes such as waist circumference and weight, visceral obesity index (VAI) can be used to evaluate visceral fat dysfunction and cardiovascular risk factors. It can more accurately reflect the visceral fat content of patients and effectively predict the occurrence of GMS [8]. The levels of HOMA-IR, VAI, and prepregnancy BMI of pregnant women with GMS were observed and compared to analyze the risk factors for GMS in pregnant women and the diagnostic values of HOMA-IR, VAI, and prepregnancy BMI in GMS, so as to provide a practical basis for the clinical diagnosis and treatment of GMS. e specific report is as follows

Methods

Results

Conclusion