Prediction of Gestational Diabetes Mellitus in Pregnant Korean Women Based on Abdominal Subcutaneous Fat Thickness as Measured by Ultrasonography

Abstract

BackgroundThis study was performed to verify the correlation between abdominal subcutaneous fat thickness (ASFT) measured by ultrasonography (US) during the first trimester of pregnancy and gestational diabetes mellitus (GDM) of the second trimester in Korean women and to establish a standard of ASFT for predicting GDM.MethodsA total of 333 singleton pregnant women participated in this study. Their ASFT was measured by US during the 10+6 to 13+6 weeks of pregnancy; then a GDM confirmatory test (100 g oral glucose tolerance test) was conducted during the 24 to 28 week period of pregnancy. Based on the GDM tests, comparative analyses of the ages of the subjects, pre-pregnancy body mass index (BMI), and weight gain during pregnancy were conducted.ResultsThe ages of the subjects and weight gains during pregnancy were not correlated to the GDM of the second trimester of pregnancy, but the pre-pregnancy BMIs (22±3.3 kg/m2) and the ASFT (1.9±0.5 cm) measurements between the control group and subjects during the first trimester of pregnancy were found to show significant differences (P<0.001). The cut-off value of the ASFT for predicting GDM was determined to be 2.4 cm (area under the curve=0.90, sensitivity 75.61%, specificity 91.78%, P<0.001). The odds ratio was 2.91 (95% confidence interval, 1.07 to 7.92; P=0.034), which was higher than the 2.4 cm ASFT.ConclusionIt was determined that ASFT as measured by US during the first trimester of pregnancy can be used to predict the risk of developing GDM during the second trimester of pregnancy and for prognosis.

Relationship between Maternal Central Obesity and the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies

“…From the included studies, 2,226 and 25,449 pregnant women were GDM and non-GDM, respectively. A total of seven studies were from non-Asian countries [14,[16][17][18][20][21][22], and four were from Asia [13,15,19,23].…”

“…The GDM was diagnosed based on two methods among all the studies: five studies used Carpenter/Coustan diagnostic criteria [17-19, 21, 22], five studies used WHO screening criteria (75 g oral glucose tolerance test) [17-19, 21, 22], and one study used self-reports [16]. In these studies, nine studies reported the relationship between maternal central obesity and GDM in the first trimester [13][14][15][16][18][19][20][21] and two reported the relationship in the second trimester [22,23]. Six studies adopted WC or WHR [13][14][15][16][17][18], two used visceral adipose tissue depth (VAT) [20,21], two used BFI or FMP [22,23], and one used maternal SFT to measured maternal central obesity [19].…”

“…Hence, maternal central obesity is significant and can reflect fat distribution or the proportion of adipose to nonadipose tissue [12]. Existing research shows that maternal central obesity has many evaluation measures, such as waist circumference (WC)/waist-hip ratio (WHR) [13][14][15][16], abdominal subcutaneous fat thickness (SFT) [17][18][19][20][21], and body fat index (BFI) [22,23], but the predictive value of these measures is not clear. The measurement accuracy and precision of WC are difficult to guarantee as it can only evaluate the condition of abdominal fat tissue, which has certain limitations [24,25].…”

Ultrasound assessment of maternal adipose tissue during 1st trimester screening for aneuploidies and risk of developing gestational diabetes

“…Martin et al reported that a VAT above the upper quartile of the normal range in the 1st trimester of pregnancy was significantly more frequent in cases than in controls. Only one study conducted by Yang et al on 333 singleton pregnancies in the 1st trimester reported that SAT was a statistically significant predictor of GDM. In a recent prospective study, De Souza et al measured SAT, VAT and total adipose tissue depth in a cohort of 485 women using a different ultrasound technique at 11‐14 weeks of gestation.…”

Simple Screening Using Ultrasonography for Prediction of Gestational Diabetes Mellitus

“…Yang et al [ 10 ] measured ASFT at 1st trimester and performed 2-step OGTT at 2nd trimester in about 300 pregnant women. The authors found that ASFT is highly correlated with the risk of GDM than well-established risk factors such as age and BMI, and suggested a cut-off value to discriminate the high-risk groups.…”