Visceral Adipose Tissue Depth in Early Pregnancy and Gestational Diabetes Mellitus - a Cohort Study

João Guilherme Alves,Alex Sandro Rolland Souza,Joel Geoffrey Ray,José Natal Figueiroa,Carla Adriane Leal De Araújo,Angélica Guimarães

doi:10.1038/s41598-020-59065-5

João Guilherme Alves, Alex Sandro Rolland Souza + Show 4 more

Open Access

https://doi.org/10.1038/s41598-020-59065-5

Copy DOI

Abstract

Some studies have suggested that abdominal visceral adipose tissue depth (VAD) measured by ultrasound in early pregnancy, may predict the future onset of gestational diabetes mellitus (GDM). Wheter this is true, independent of pre-pregnancy body mass index (BMI), has been debated, leading the current study. A prospective cohort study was completed, in which VAD was measured at around 14 weeks’ gestation. GDM was later assessed by an oral glucose tolerance test at 24 to 28 weeks, according to the IADPSG criteria. Logistic regression analysis and receiver operating curve (ROC) analysis were used to estimate the predictive value of VAD, above and beyond pre-pregnancy BMI. 627 pregnant women were enrolled, and 518 completed the study. VAD was measured at a mean of 14.4 weeks’ gestation. 87 women (16.8%) subsequently developed GDM. The unadjusted odds ratio (OR) for developing GDM was 1.99 (95% CI 1.59–2.46) per 1-cm increase in VAD. After adjusting for maternal BMI and age, the OR was 2.00 (95% CI 1.61 to 2.50). The ROC under the curve for developing GDM was higher for VAD (0.70, 95% CI 0.63 to 0.75) than for pre-pregnancy BMI (0.57 95% CI 0.50 to 0.64) (p < 0.001). In conclusion, higher VAD may better predict GDM than pre-pregnancy BMI.

Highlights

Gestational diabetes mellitus (GDM) – glucose intolerance, resulting in new onset in pregnancy–has emerged as a global public health concern[1]
The mean (SD; 95% CI) visceral adipose tissue depth (VAD) by ultrasound was 5.44 (±1.27) cm; 95% CI 5.33–5.55. 87 (16.8%) pregnant women developed gestational diabetes mellitus (GDM) according to IASDPG criteria
VAD, age and body mass index (BMI) pre-pregnancy differed between women who did and did not develop GDM (Table 2)

Summary

Introduction

Gestational diabetes mellitus (GDM) – glucose intolerance, resulting in new onset in pregnancy–has emerged as a global public health concern[1]. The International Association of Diabetes recommends screening for GDM among all pregnant women, at 24 to 28 weeks’ gestation, using a 75-g oral glucose tolerance test (OGTT)[5]. Thaware et al.[14] showed that ultrasonography‐measured VAD in early pregnancy aided in the early recognition of GDM. They reported that this method, compared with an OGTT alone, could reduce by half number of pregnant women requiring OGTT screening. It is not clear whether ultrasonography-measured VAD offers improve discrimination in the detection of GDM compared with using pre-pregnancy body mass index (BMI). We carried out a prospective cohort study among a large sample of pregnant women, to assess the role of VAD in the prediction of GDM

Methods

Results

Conclusion