Predictability of HOMA-IR for Gestational Diabetes Mellitus in Early Pregnancy Based on Different First Trimester BMI Values

Abstract

Objective: To investigate the ability of homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy for predicting gestational diabetes mellitus (GDM) in Chinese women with different first-trimester body mass index (FT-BMI) values. Methods: Baseline characteristics and laboratory tests were collected at the first prenatal visit (6–12 weeks of gestation). GDM was diagnosed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression were applied to identify the association between HOMA-IR and GDM. The cutoff points for predicting GDM were estimated using receiver operating characteristic (ROC) curve analysis. Results: Of the total of 1343 women, 300 (22.34%) were diagnosed with GDM in the 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression verified HOMA-IR as a significant risk factor for GDM in the normal weight subgroup (FT-BMI < 24 kg/m2) (adjusted OR 2.941 [95% CI 2.153, 4.016], P < 0.001), overweight subgroup (24.0 kg/m2 ≤ FT-BMI < 28.0 kg/m2) (adjusted OR 3.188 [95% CI 2.011, 5.055], P < 0.001), and obese subgroup (FT-BMI ≥ 28.0 kg/m2) (adjusted OR 9.415 [95% CI 1.712, 51.770], p = 0.01). The cutoff values of HOMA-IR were 1.52 (area under the curve (AUC) 0.733, 95% CI 0.701–0.765, p < 0.001) for all participants, 1.43 (AUC 0.691, 95% CI 0.651–0.730, p < 0.001) for normal weight women, 2.27 (AUC 0.760, 95% CI 0.703–0.818, p < 0.001) for overweight women, and 2.31 (AUC 0.801, 95% CI 0.696–0.907, p < 0.001) for obese women. Conclusions: Increased HOMA-IR in early pregnancy is a risk factor for GDM, and HOMA-IR can be affected by body weight. The cutoff value of HOMA-IR to predict GDM should be distinguished by different FT-BMI values.

Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study

“…Early detection of insulin resistance (IR) in pregnant women has been shown to assist in predicting the onset of GDM before clinical diagnosis ( 8 , 9 ). The TyG index, calculated from fasting plasma glucose (FPG) and serum triglycerides (TG), is considered a straightforward, economical, replicable, and reliable surrogate for IR ( 10 , 11 ).…”

Assessment of serum biotin levels and its association with blood glucose in gestational diabetes mellitus

“…Fasting insulin and HOMA-IR which are considered as markers of insulin resistance [21] are slightly elevated in GDM mothers as compared to controls, though it was not statistically significant in our study. Studies have shown that increased HOMA-IR in early pregnancy can be used as a predictive marker of gestational diabetes mellitus and were found to be higher in GDM mothers as compared to control mothers [22] , [23] .…”

The yield of early-pregnancy homeostasis of model assessment -insulin resistance (HOMA-IR) for predicting gestational diabetes mellitus in different body mass index and age groups

“…The association of HOMA-IR and GDM development in different BMI categories of pregnant women was investigated by Duo et al [ 26 ]. A higher HOMA-IR index was a risk factor for GDM development in all three categories of BMI.…”

“…Considering the prevalence of GDM 10% in general population [ 25 ], a relative risk of 2.9 [ 26 ], power of 80%, and α = 0.05, the sample sizes in each subgroup was calculated as 156. In the case of advanced maternal age group, regarding the prevalence of about 21% [ 27 ] and according to the above considerations, the sample size of advance age group was calculated to be 56 participants.…”