Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn

Pazhohan, Azar; Moradali, Monireh Rezaee; Pazhohan, Nahideh

doi:10.1080/14767058.2017.1402876

Cited by 39 publications

(63 citation statements)

References 27 publications

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“…Currently, a single study has assessed the TyG index as a predictor of GDM in Iranian women who attended health centers. Women with TyG index values in the third tertile showed a fivefold risk of developing GDM 9 . Nevertheless, baseline FPG, triglycerides, and BMI at 9 weeks of pregnancy were higher in the Iranian women than those encountered in Latin American women at 13 weeks of pregnancy in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Also, impaired glucose tolerance was not determined at enrollment in the Iranian women. Conversely to our sample, Pazhohan et al 9 found a statistical difference in age and BMI between GDM cases and non‐GDM cases, while parity and previous GDM were not reported.…”

Section: Discussionmentioning

confidence: 99%

“…However, wide confidence intervals in association measures, comparisons based on quartile or percentile categorizations, retrospective designs, and several confounders were the clear limitations in previous studies. Currently, LGA neonates were associated with higher TyG values in the first trimester of pregnancy in an individual study 9 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, women were categorized by tertiles of the TyG index to compare GDM cases distribution and the risk of developing GDM, using the lowest tertile as a reference. A minimum of 93 participants was required using a sample size formula for a controlled study with a confidence of 95%, a power of 80%, an expected proportion of the event (GDM) of 7%, and an odds ratio of 4.04 9 …”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, studies describe a variable diagnostic performance due to a distinct basal obstetric risk of the population, gestational age at the time of evaluation, and the use of different GDM diagnostic algorithms. Recently, the triglyceride and glucose (TyG) index was suggested as an early predictor of GDM 9 . However, this finding was based on a single triglyceride measurement in Iranian women.…”

Section: Introductionmentioning

confidence: 99%

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Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus

Sánchez‐García

Rodríguez-Gutiérrez

Saldívar-Rodríguez

et al. 2020

Intl J Gynecology & Obste

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Objective To assess the risk of gestational diabetes mellitus (GDM) according to the triglyceride and glucose (TyG) index values during the first trimester of pregnancy in Latin American women. Methods Pregnant women were enrolled at their first prenatal visit at the Obstetric Division in the University Hospital “Dr. José E. González”. Triglycerides and fasting plasma glucose (FPG) were collected to determine the TyG index. GDM diagnosis was performed by a single‐step 2‐hour 75‐g oral glucose tolerance test. Generalized linear models were used to determine risk ratios; pregnancy outcomes at delivery were collected from the hospital medical records. Results A total of 164 pregnant women were included. GDM was present in 29 (17.7%) women. No significant differences in age, first‐trimester body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), family history of diabetes, and TyG index were observed between GDM cases and the reference group without GDM. The adjusted analysis showed no association between TyG and GDM (risk ratio [RR] 1.03, 95% confidence interval [CI] 0.57–1.88]). Higher TyG index values between women with and without a diagnosis of GDM in the second trimester were observed. No significant differences were identified in pregnancy outcomes, although a trend was observed for hyperbilirubinemia in women with first‐trimester TyG index values greater than 8.7. Conclusions Our findings do not support the use of the TyG index for GDM prediction in Latin American women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus

Sánchez‐García

Rodríguez-Gutiérrez

Saldívar-Rodríguez

et al. 2020

Intl J Gynecology & Obste

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Maternal metabolic factors and the association with gestational diabetes: A systematic review and meta‐analysis

Habibi

Mousa

Tay

et al. 2022

Diabetes Metabolism Res

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Gestational diabetes (GDM) is associated with several adverse outcomes for the mother and child. Higher levels of individual lipids are associated with risk of GDM and metabolic syndrome (MetS), a clustering of risk factors also increases risk for GDM. Metabolic factors can be modified by diet and lifestyle. This review comprehensively evaluates the association between MetS and its components, measured in early pregnancy, and risk for GDM. Databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Embase, and Cochrane Library) were searched from inception to 5 May 2021. Eligible studies included ≥1 metabolic factor (waist circumference, blood pressure, fasting plasma glucose (FPG), triglycerides, and high-density lipoprotein cholesterol), measured at <16 weeks' gestation. At least two authors independently screened potentially eligible studies. Heterogeneity was quantified using I 2 . Data were pooled by random-effects models and expressed as odds ratio and 95% confidence intervals (CIs). Of 7213 articles identified, 40 unique articles were included in meta-analysis. In analyses adjusting for maternal age and body mass index, GDM was increased with increasing FPG (odds ratios [OR] 1.92; 95% CI 1.39-2.64, k = 7 studies) or having MetS (OR 2.52; 1.65, 3.84, k = 3). Women with overweight (OR 2.17; 95% CI 1.89, 2.50, k = 12) or obesity (OR 4.34; 95% CI 2.79-6.74, k = 9) also were at increased risk for GDM.Early pregnancy assessment of glucose or the MetS, offers a potential opportunity to detect and treat individual risk factors as an approach towards GDM prevention; weight loss for pregnant women with overweight or obesity is not recommended. Systematic review registration: PROSPERO CRD42020199225.

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The role of dietary fiber on preventing gestational diabetes mellitus in an at-risk group of high triglyceride-glucose index women: a randomized controlled trial

Cao,

Sheng,

Zhang

et al. 2023

Endocrine

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BackgroundPregnant women with a high triglyceride-glucose (TyG) index during early pregnancy may increase the risk of gestational diabetes mellitus (GDM), and dietary ber could play an important role in glucose and lipid metabolism. However, no trials have tested the effects of dietary ber on preventing GDM in women with a high TyG index. This study aims to investigate whether GDM can be prevented by dietary ber supplementation in women with a TyG index ≥ 8.5 during early pregnancy (< 20 weeks). MethodsA randomized clinical trial was performed among 295 women with a TyG index ≥ 8.5 before 20 weeks of gestation, divided into a ber group (24 g dietary ber powder/day) or a control group (usual care). The intervention was conducted from 20 to 24 + 6 gestational weeks, and both groups received guidance on exercise and diet. The primary outcomes were the incidence of GDM diagnosed by a 75 g oral glucose tolerance test (OGTT) at 25-28 gestational weeks, and levels of maternal blood glucose, lipids.Secondary outcomes include gestational hypertension, postpartum haemorrhage, preterm birth, and other maternal and neonatal complications. ResultsGDM occurred at 11.2% (10 of 89) in the ber group, which was signi cantly lower than 23.7 (44 of 186) in the control group (P = 0.015). The mean gestational weeks increased dramatically in the ber group compared with the control group (38.58 ± 1.44 weeks vs. 39.07 ± 1.08 weeks, P = 0.016). The incidence of preterm birth was 2.3% (2 of 86) of women randomized to the ber group compared with 9.4% (17 of 181) in the control group (P = 0.032). The concentrations of 2 hour postprandial blood glucose showed statistically higher in the control group compared with the intervention group (6.69 ± 1.65 mmol/L vs. 6.45 ± 1.25 mmol/L, P = 0.026);. There were no other signi cant differences between groups in lipid pro le values, or other secondary outcomes. ConclusionAn intervention with dietary ber supplementation during pregnancy may prevent GDM and preterm birth in women with a TyG index ≥ 8.5 before 20 weeks of gestation.

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Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn

Abstract: Based on our findings, TyG index is more robust early predictors of GDM and LGA in Iranian women.

Cited by 39 publications

References 27 publications

Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus

Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus

Maternal metabolic factors and the association with gestational diabetes: A systematic review and meta‐analysis

The role of dietary fiber on preventing gestational diabetes mellitus in an at-risk group of high triglyceride-glucose index women: a randomized controlled trial

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