AST-to-ALT ratio in the first trimester and the risk of gestational diabetes mellitus

An, Rongjing; Ma, Shujuan; Zhang, Na; Lin, Huijun; Xiang, Tianyu; Chen, Mengshi; Tan, Hongzhuan

doi:10.3389/fendo.2022.1017448

Cited by 12 publications

(1 citation statement)

References 42 publications

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“…The covariates in our study were selected based on the original study, previous studies having a correlation to diabetes or prediabetes, and our clinical expertise ( 18 , 22 , 23 , 28 , 29 ). Covariates included the following variables: (i)categorical variables: sex, smoking status, family history of diabetes, and drinking status.…”

Section: Methodsmentioning

confidence: 99%

Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study

Han

Huang

et al. 2023

Front. Endocrinol.

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ObjectiveEvidence regarding the relationship between body mass index (BMI) and reversion to normoglycemia from prediabetes is still limited. The purpose of our study is to survey the link of BMI on reversion to normoglycemia among patients with impaired fasting glucose (IFG).MethodsThis study, a retrospective cohort, covered 32 regions and 11 cities in China and collected 258,74 IFG patients who underwent a health check from 2010 to 2016. We investigated the association between baseline BMI and reversion to normoglycemia in patients with IFG using the Cox proportional-hazards regression model. The nonlinear relationship between BMI and reversion to normoglycemia was determined using a Cox proportional hazards regression with cubic spline functions and smooth curve fitting. In addition, we also performed a series of sensitivity analyses and subgroup analyses. A competing risk multivariate Cox regression was performed using progression to diabetes as a competing risk for reversal of normoglycemic events.ResultsAfter adjusting covariates, the results showed that BMI was negatively related to the probability of reversion to normoglycemia (HR=0.977, 95%CI:0.971-0.984). Compared with participants with normal BMI(<24kg/m2), overweight (BMI:24-28kg/m2) participants with IFG had a 9.9% lower probability of returning to normoglycemia (HR=0.901,95%CI:0.863-0.939), while obese patients (BMI ≥ 28kg/m2) had a 16.9% decreased probability of reverting from IFG to normoglycemia (HR=0.831,95%CI:0.780-0.886). There was also a nonlinear relationship between them, and the inflection point of BMI was 21.7kg/m2. The effect sizes (HR) on the left sides of the inflection point were 0.972(95%CI:0.964-0.980). The competing risks multivariate Cox’s regression and sensitivity analysis demonstrated the robustness of our results.ConclusionThis study demonstrates a negative and nonlinear relationship between BMI and reversion to normoglycemia in Chinese patients with IFG. Minimizing BMI to 21.7 kg/m2 in patients with IFG through aggressive intervention may significantly increase the probability of returning to normoglycemia.

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Section: Methodsmentioning

confidence: 99%

Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study

Han

Huang

et al. 2023

Front. Endocrinol.

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Elevated liver enzymes in the first trimester are associated with gestational diabetes mellitus: A prospective cohort study

Cui,

Yang,

et al. 2024

Diabetes Metabolism Res

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AimsPrevious studies have found that a single liver enzyme may predict gestational diabetes mellitus (GDM), but the results have been inconsistent. This study aimed to explore the associations of liver enzymes in early pregnancy with risk of GDM, as well as to independently rank risk factors.MethodsThis prospective cohort study included 1295 women who underwent liver enzyme measurements during early pregnancy and completed GDM assessment in mid‐pregnancy. Logistic regression and restricted cubic spline analyses were conducted to assess the relationship between liver enzymes and risk of GDM. Back‐propagation artificial neural network was performed to rank independently risk factors of GDM.ResultsWomen diagnosed with GDM exhibited significantly higher levels of liver enzymes than those without GDM (all p < 0.05). The highest quartile of liver enzymes was associated with higher risk of GDM compared with the lowest quartile, with adjusted odds ratio (ORs) ranging from 2.76 to 8.11 (all p < 0.05). Moreover, the ORs of GDM increased linearly with liver enzymes level (all P for overall association <0.001). Furthermore, Back‐propagation artificial neural network identified γ‐gamma‐glutamyl transferase (GGT) as accounting for the highest proportion in the ranking of GDM risk prediction weights (up to 20.8%).ConclusionsSingle or total elevations of liver enzymes in early pregnancy could predict the GDM occurrence, in which GGT, alkaline Phosphatase, and aspartate aminotransferase were the three most important independent risk factors.

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A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Pregnant Chinese Women

Duo,

Song,

Qiao

et al. 2023

Diabetes Ther

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AST-to-ALT ratio in the first trimester and the risk of gestational diabetes mellitus

Cited by 12 publications

References 42 publications

Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study

Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study

Elevated liver enzymes in the first trimester are associated with gestational diabetes mellitus: A prospective cohort study

A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Pregnant Chinese Women

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