Epicardial adipose tissue thickness as a potential predictor of gestational diabetes mellitus: a prospective cohort study

Abstract

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder that can occur during pregnancy and is associated with a long-term risk of both maternal and neonatal comorbidities. This study aimed to investigate the association between echocardiographic epicardial adipose tissue (EAT) and the risk for GDM during the early second trimester of pregnancy. Method: We recruited all singleton pregnancies between January 2014 and December 2018 at 16 weeks + 0 days to 19 weeks + 6 days. We then used generalized linear models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for EAT as a potential predictor for GDM. Receiver-operating-characteristic (ROC) analysis was then conducted to investigate the discriminative capacity of any individual maternal factor for the prediction of GDM. Results: In total, our study involved 314 pregnant women with GDM and 1832 pregnant women without GDM. Multivariate regression analysis revealed that EAT thickness (OR = 2.87; 95% CI: 2.49-3.31) was significantly associated with the presence of GDM (P < 0.001). Furthermore, EAT thickness was also significantly associated with a range of adverse outcomes in the GDM group, including large size for gestational age, neonatal hypoglycemia, admission to the neonatal intensive care unit, preterm delivery, and hyperbilirubinemia (P < 0.001). ROC analysis revealed that the area under the curve was 0.790 (95% CI: 0.768-0.812). When the cutoff value for EAT thickness was set to 5.49 mm, the sensitivity was 95.2% and the specificity was 50.5%. Conclusions: Echocardiographic EAT thickness is positively and significantly associated with both the risk of GDM and adverse outcomes related to GDM. Echocardiographic EAT has the potential to predict GDM prior to actual clinical diagnosis.

Adipose tissue function in healthy pregnancy, gestational diabetes mellitus and pre-eclampsia

“…Placenta in pre-eclampsia had a higher total and neutral lipid (triglyceride and cholesteryl ester) content than in BMI-matched controls, which is preliminary evidence suggesting that ectopic lipid droplets may form in the placenta [ 95 ]. In addition, epicardial adipose thickness, an ectopic site of fat accumulation and a marker of visceral fat, was shown to predict both PE and GDM [ 96 – 98 ].…”

Lack of association between IGF2BP2 rs4402960 polymorphism and gestational diabetes mellitus: a case–control study, meta-analysis and trial sequential analysis

“…Participants were not eligible if they had a history of diabetes (including GDM in previous pregnancies). The control group consisted of 1216 middle-aged (18-45 years) non-diabetic Chinese women from the prospective hospital-based cohort [13]. We excluded those who presenting with maternal-related abnormalities, mothers with a history of drug abuse and depression, carriers of a blood-transmitted infectious disease, hypertension, and cardiovascular diseases.…”

Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis

“…Study characteristics—of the studies reporting associations of clinical, sociocultural factors or composites of multiple risk factors among women with GDM 55 , 59 , 60 , 65 , 69 , 78 , 80 , 85 , 86 , 96 , 97 , 103 , 104 , 113 , 137 – 171 , 14 compared differences in adverse perinatal outcomes between different races, ethnicities, or countries of origin 69 , 96 , 147 – 150 , 152 , 154 – 160 , and six included multiple risk factors as a composite variable 78 , 86 , 141 , 144 , 162 , 163 . Four studies investigated psychological factors, and five reported on concomitant presence of pre-eclampsia or hypertensive disorders of pregnancy in women with GDM.…”