Visceral Adipose Tissue Depth Research Articles

The association between visceral adipose thickness and gestational diabetes mellitus in the first trimester

Objective: To investigate the association between visceral adipose tissue (VAT) thickness in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods: Based on the Qingdao Women and Children Health Cohort, pregnant women in the first trimester (11-13+6 weeks of gestation) were enrolled in this cohort study between May 2019 and October 2022. The VAT was measured in first trimester and determined as the distance from the inner margin of the rectus abdominis muscle to the anterior wall of the great artery using multi-functional color ultrasound. The 75 g oral glucose tolerance test (OGTT) results were followed up at 24-28 weeks and the participants were divided into GDM group and non-GDM group. The pregnant women were divided into 4 groups according to the VAT quartile. Log-binomial model and linear regression model were used to analyze the association between VAT and GDM/blood glucose. Results: A total of 3 686 pregnant women were included in this study, the mean age of participants was (30.56±4.05) years and 722 were diagnosed with GDM, with an incidence of 19.6%. The log-binomial regression model results showed that compared with VAT thickness Q1 (VAT<14.70 mm), the GDM risk in Q3 (21.65≤VAT≤29.69 mm) and Q4 (VAT ≥29.70 mm) increased by 34% [RR(95%CI): 1.34 (1.08-1.67)], and 61% [RR(95%CI): 1.61 (1.30-2.00)], respectively. Among women with gestational age<35 years old, compared with VAT thickness Q1, the risk of GDM increased by 42% in Q3 [RR(95%CI): 1.42 (1.22-1.65)] and 70% [RR(95%CI): 1.70 (1.46-1.98)] in Q4, whereas no associations were found in women with gestational age ≥35 years old (P>0.05). The association between VAT and GDM risk was only found in pregnant women with pre-pregnancy BMI <24.0 kg/m2, and the GDM risk increased by 57% [RR(95%CI): 1.57 (1.22-2.04)] in Q3 and 65% [RR(95%CI): 1.65 (1.24-2.19)] in Q4 compare with Q1. The results of multiple linear regression analysis showed that VAT was positively correlated with fasting blood glucose, 1-hour blood glucose after 75 g OGTT and 2-hours blood glucose after 75 g OGTT (all Pfor trend<0.001). Conclusion: High VAT thickness in early pregnancy is an independent risk factor for GDM, and the GDM risk increases with the raising of VAT depth.

Association of body composition in early pregnancy with gestational diabetes mellitus: A meta-analysis.

IntroductionBody composition as dynamic indices constantly changes in pregnancy. The use of body composition indices in the early stages of pregnancy has recently been considered. Therefore, the current meta-analysis study was conducted to investigate the relationship between body composition in the early stages of pregnancy and gestational diabetes.MethodValid databases searched for papers published from 2010 to December 2021 were based on PRISMA guideline. Newcastle Ottawa was used to assess the quality of the studies. For all analyses, STATA 14.0 was used. Mean difference (MD) of anthropometric indices was calculated between the GDM and Non-GDM groups. Pooled MD was estimated by “Metan” command, and heterogeneity was defined using Cochran’s Q test of heterogeneity, and I 2 index was used to quantify heterogeneity.ResultsFinally, 29 studies with a sample size of 56438 met the criteria for entering the meta-analysis. Pooled MD of neck circumference, hip circumference, waist hip ratio, and visceral adipose tissue depth were, respectively, 1.00 cm (95% CI: 0.79 to 1.20) [N = 5; I^2: 0%; p: 0.709], 7.79 cm (95% CI: 2.27 to 13.31) [N = 5; I2: 84.3%; P<0.001], 0.03 (95% CI: 0.02 to 0.04) [N = 9; I2: 89.2%; P<0.001], and 7.74 cm (95% CI: 0.11 to 1.36) [N = 4; I^2: 95.8%; P<0.001].ConclusionIncreased neck circumference, waist circumference, hip circumference, arm circumference, waist to hip ratio, visceral fat depth, subcutaneous fat depth, and short stature increased the possibility of developing gestational diabetes. These indices can accurately, cost-effectively, and affordably assess the occurrence of gestational diabetes, thus preventing many consequences with early detection of gestational diabetes.

The Early Sonographic Prediction of Gestational Diabetes in Women From India

Objective: The purpose of this study was to look for the earliest, cost -effective method that can be added to the routine antenatal screening for identifying patients who might develop gestational diabetes mellitus (GDM) in a proactive manner, as opposed to the current reactive approach of screening and treating GDM, during the second trimester of pregnancy. Materials and Methods: 190 singleton pregnant women in the age group 18-35 years were selected for the study. On these women two step assessment was done. The current project was carried out to utilize sonography as an early, cost-effective method which could be added to routine antenatal screening for identifying patients, at risk for developing GDM. Results: Body mass index was found to have a significant association in those patients with GDM with a P &lt; .001. There was a significant association between subcutaneous adipose tissue (SAT) depth and occurrence of GDM, with a P-value of &lt;.001. Also, in the present study, the occurrence of GDM significantly increased with a rise in visceral adipose tissue (VAT), and there was a significant association between the two, with P &lt; .001. It was noted that there were greater incidences of GDM as VAT depth increased. The existence of GDM greatly increased with a rise in total abdominal tissue (TAT), and there was a significant association between the two, with P &lt; .001 Conclusion: The sonographic measurement of SAT, VAT, and TAT, could be potential marker to identify probable events for the development of GDM, among Asian Indian women who tend to have T2DM, due to differential distribution of fat.

Maternal Visceral Adipose Tissue and Risk of Having a Small or Large for Gestational Age Infant.

To determine whether first-trimester visceral adipose tissue (VAT) depth is associated with small-for-gestational-age (SGA; <10th percentile) or large-for-gestational-age (LGA; >90th percentile) birthweight, including when taking into consideration ethnicity-specific birthweight curves. We conducted a prospective cohort study involving 452 women with a singleton livebirth. Maternal VAT depth was measured by ultrasound at 11 to 14 weeks gestation. Newborn weight was plotted on population-based and ethnicity-specific birthweight percentile curves. Modelling was performed using linear and logistic regression, adjusting for parity, smoking status, and weight gain. Mean maternal age was 32.9 ± 4.7 years, and mean VAT depth was 4.1 ± 1.7 cm. Using a population-based curve, each 1-cm increase in VAT depth was associated with a 1.5 (95% CI 0.03-3.0) higher birthweight percentile. Taking into account ethnicity-specific curves, a 1-cm higher VAT depth was associated with a 1.7 (95% CI 0.02-3.3) greater birthweight percentile. Using a population-based curve, comparing VAT depth Q4 with VAT depth Q1-3, the adjusted odds ratio (aOR) for LGA was 1.9 (95% CI 0.8-4.1); with ethnicity-specific curves, the aOR for LGA was 1.5 (95% CI 0.7-3.2). The aOR for SGA was 0.8 (95% CI 0.4 to 1.7) comparing Q1 with Q2-4 VAT depth. Higher first-trimester maternal VAT depth was associated with a somewhat greater newborn weight percentile, which varies by which birthweight curve is used. There were marginally higher odds of giving birth to an LGA infant for women in highest quartile for VAT depth, with no evident association with SGA.

Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery – a cohort study

BackgroundGestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tissue (VAT) measurement by ultrasound during the first half of pregnancy can predict the occurrence of GDM during the third trimester.MethodsA prospective cohort study of 133 pregnant women with gestational age ≤20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM.ResultsAccording to the ROC curve, a 45mm threshold was identified as the best cut-off value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9–61.1) and 8.9 (95%CI 1.9–42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9–142.6) and 14.4 (95%CI 1.7–125.7), respectively. Among pre-gravid obese patients, a 45mm threshold did not reach statistical significance to predict GDM.ConclusionThe high and significant OR found before and after adjustments provides additional evidence of a strong association between VAT and GDM. It appears that VAT measurement during the first half of pregnancy has great potential in identifying non-obese women at high risk for GDM. This evidence can assist obstetricians in correctly allocating resources among populations of pregnant women at risk, determined not only by pre-gravid body mass index (BMI).

Ultrasound markers for prediction of gestational diabetes mellitus in early pregnancy in Egyptian women: observational study

Introduction Excess visceral adipose tissue (VAT) is associated with insulin resistance in early pregnancy and VAT measurement better explains the association between obesity and insulin resistance than the body mass index. First trimester homeostatic model assessment of insulin resistance (HOMA-IR) or the insulin sensitivity index proved to have positive correlation with late development of gestational diabetes mellitus (GDM) in late pregnancy. Greater VAT depth in the first trimester of pregnancy will be associated with hyperglycemia at 24–28 weeks’ gestation. Objectives To study the relationship between abdominal visceral adiposity and insulin resistance in early pregnancy as a predictor for development of GDM in late pregnancy. Patients and methods This prospective cohort study included 83 pregnant women at 11–14-week gestation subjected to abdominal adiposity measurement through VAT and subcutaneous adipose tissue (SAT) measurements, then at 16–22 completed a two-hour 75 g OGTT and fasting one-hour and two-hour serum insulin concentration. The HOMA-IR and insulin resistance index (IRI) were calculated. Patients were divided into two groups: group I: pregnant women who did not developed GDM; group 2: pregnant women who developed GDM. Results Significant statistical difference in both groups as regarding VAT (p = .001). With mean ± S.D. of VAT increase in Group 2. Mean ± S.D. of HOMA-IR increase in group 2 with significant statistical difference in both groups (p =.001). Also mean ± S.D. of ISI increase in group 2 with significant statistical difference in both groups (p = .001). There was positive relationship between visceral adiposity and HOMA-IR and negative relationship between visceral adiposity and insulin sensitivity. Also, in this study, there was no significant relation between SAT and HOMA-IR. Conclusions From our study, we concluded that measurement of VAT during a routine 11–14 weeks’ gestation ultrasound might improve the performance of screening for GDM and correlates with metabolic risk factors even better than BMI.

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

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.

Clinical utility of ultrasonography-measured visceral adipose tissue depth as a tool in early pregnancy screening for gestational diabetes: a proof-of-concept study.

To examine, in a proof-of-concept study, the ability of visceral adipose tissue depth and subcutaneous fat depth measured in early pregnancy to predict subsequent gestational diabetes, and to assess the performance of these measures as screening tests for gestational diabetes compared with use of the current UK criteria. A total of 100 women in early pregnancy were recruited from a maternity hospital in Belfast, UK. Visceral adipose tissue depth and subcutaneous fat depth were measured, and each participant underwent a 75-g oral glucose tolerance test at 28 weeks' gestation for the diagnosis of gestational diabetes using WHO 2013 criteria. Eighty women completed the study, of whom 15 (19%) developed gestational diabetes. Increasing visceral adipose tissue depth, but not subcutaneous fat depth, was associated with greater gestational diabetes risk after adjusting for confounding factors (odds ratio for a 1-sd rise 2.09, 95% CI 1.06-4.12; P=0.03). Visceral adipose tissue depth ≥4.27 cm had greater sensitivity compared with current National Institute of Health and Care Excellence criteria (87% vs 40%, respectively; P=0.02) and similar specificity (62% vs 74%, respectively; P=0.15) for identifying gestational diabetes. Ultrasonography-measured visceral adipose tissue in early pregnancy is a potential clinical tool for improving sensitivity of selective screening for gestational diabetes, which, compared with universal oral glucose tolerance testing, is likely to reduce by half the numbers requiring this test. Further larger studies are now required for confirmation, including investigation into impact on clinical outcomes.

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

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.

Difference in Visceral Adipose Tissue in Pregnancy and Postpartum and Related Changes in Maternal Insulin Resistance.

To measure the difference between first-trimester and postpartum visceral adipose tissue (VAT), the agreement of this difference with change in body mass index, and whether a difference in VAT is associated with insulin resistance or glucose mishandling. Prospective study of 93 women with singleton pregnancies without a history of diabetes. Visceral adipose tissue depth was sonographically assessed at 11 to 14 weeks and at 6 to 12 weeks postpartum. Metabolic measures, sampled at 24 to 28 weeks and 6 to 12 weeks postpartum, included homeostatic model assessment of insulin resistance, insulin sensitivity index composite, and area under the 75-g oral glucose tolerance test curve. First-trimester VAT depth explained only 37% (95% confidence interval [CI], 22-52) of the variation in postpartum VAT depth. There was limited agreement between the net change in postpartum minus first-trimester VAT depth and that same net change for body mass index (Cohen's kappa, 0.26; 95% CI, 0.05-0.47). Those with a net gain in VAT depth demonstrated poorer insulin sensitivity index postpartum than women with a net regression in VAT depth-a difference of -2.0 (95% CI, -3.3 to -0.69). Sonographic assessment of postpartum VAT is feasible and may provide insight to metabolic changes between pregnancy and postpartum, beyond body mass index.

Ethnic Differences in Visceral Adiposity Measured in Early Pregnancy.

To determine if visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) depth in early pregnancy differs by maternal ethnicity. We prospectively evaluated 482 women without pre-pregnancy diabetes. All underwent sonographic measurement of VAT and SAT depth at 11 to 14 weeks' gestation. SAT did not differ between groups, but VAT did. Compared with Canadian-born women (3.9 cm, 95% CI 3.7-4.1), mean VAT depth was higher among Latin American (4.6 cm, 95% CI 4.1-5.2), Sub-Saharan African (5.0 cm, 95% CI 4.0-6.1), and Caribbean (6.0 cm, 95% CI 4.8-7.3) women. Adjusting for age, parity, and 1/height2, the relative risks of having a VAT depth >80th percentile were 1.69 (95% CI 1.05-2.73) for Latin American, 2.24 (95% CI 1.28-3.93) for Sub-Saharan African, and 3.34 (95% CI 1.91-5.84) for Caribbean women, relative to Canadian-born women. Women from these world regions also had a greater percentage of preterm births and emergency CSs. VAT differs appreciably among certain ethnic groups, which may reflect their predisposition to adverse pregnancy outcomes.

Abdominal Adiposity and Insulin Resistance in Early Pregnancy

BackgroundHigh pre-pregnancy body mass index is a known risk factor for gestational diabetes mellitus, but the contribution of abdominal adiposity to insulin resistance (IR) in pregnancy is not well understood. We assessed the association between abdominal adiposity in early pregnancy and IR. MethodsWe completed a prospective cohort study of 79 pregnant women. Visceral adipose tissue (VAT) depth was measured by ultrasonography at 11 to 14weeks’ gestation, at the time of routine fetal nuchal translucency assessment. A two-hour 75g oral glucose tolerance test was subsequently completed at 16 to 22weeks’ gestation and IR was estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) as well as by the insulin sensitivity index. ResultsAfter adjusting for maternal age, parity, ethnicity, and pre-pregnancy BMI, VAT depth explained 42% of the variance in HOMA-IR, which was slightly better than the variance in the multivariable model examining HOMA-IR and pre-pregnancy BMI (40%). For the insulin sensitivity index, the model variance values were 36% and 32%, respectively. ConclusionMeasurement of maternal adipose tissue depth at the time of routine first-trimester ultrasonography may provide additional information about maternal IR, beyond pre-pregnancy BMI.

Abdominal Visceral Adiposity in the First Trimester Predicts Glucose Intolerance in Later Pregnancy

OBJECTIVETo assess whether abdominal adiposity in early pregnancy is associated with a higher risk of glucose intolerance at a later gestational stage.RESEARCH DESIGN AND METHODSSubcutaneous and visceral fat was measured with ultrasonography at ∼12 weeks' gestation. A 50-g glucose challenge test (GCT) was performed between 24 and 28 weeks' gestation. The risk of having a positive GCT (≥7.8 mmol/l) was determined in association with subcutaneous and visceral adipose tissue depths above their respective upper-quartile values relative to their bottom three quartile values.RESULTSSixty-two women underwent GCTs. A visceral adipose tissue depth above the upper quartile value was significantly associated with a positive GCT in later pregnancy (adjusted odds ratio 16.9 [95% CI 1.5–194.6]). No associations were seen for subcutaneous adipose tissue.CONCLUSIONSMeasurement of visceral adipose tissue depth in early pregnancy may be associated with glucose intolerance later in pregnancy.