Visceral adiposity and insulin resistance in the prediction of gestational diabetes mellitus in early pregnancy: a prospective observational study

Abstract

Objective The aim was to study the relationship between abdominal adiposity and insulin resistance in the prediction of gestational diabetes mellitus (GDM) in early pregnancy. Background There is a positive association between high prepregnancy BMI and risk of GDM. Patients and methods This prospective cohort study included 83 women at 11–14 weeks for abdominal adiposity measurement and at 16–22 weeks for oral glucose tolerance test measurement. The patients were divided into two groups: group 1included patients who did not develop GDM and group 2included patients who developed GDM. This study was conducted at the Obstetrics and Gynecology Department, Menoufia University Hospital between March 2015 and March 2017. Results There was a significant statistical difference between both groups as regards visceral adipose tissue (VAT) depth (P = 0.001) with a mean ± SD of VAT depth (5.85 ± 0.47) increase in group 2. There was a positive relationship between visceral adiposity and the homestatic model assessment of insulin resistance and a negative relationship between visceral adiposity and insulin sensitivity. The γ2 values examining the association between VAT depth and measured homestatic model assessment of insulin resistance or insulin sensitivity were higher than the γ2 examining the association between BMI and measured homestatic model assessment of insulin resistance or insulin sensitivity index. Conclusion Measurement of visceral adiposity during the 11–14 weeks' gestation by ultrasound might improve the performance of screening for GDM better than BMI.