Short Body Height and Pre-pregnancy Overweight for Increased Risk of Gestational Diabetes Mellitus: A Population-Based Cohort Study

Abstract

Background: Short height is associated with gestational diabetes mellitus (GDM) but the underlying mechanism remains unknown. This study aims to explore whether short height has a synergistic effect with pre-pregnancy overweight/obesity and undue weight gain on the risk of GDM.Methods: We recruited 19,962 singleton pregnant women from their first antenatal care visit in urban Tianjin, China, between October 2010 to August 2012. At 24–28 weeks of gestation, women underwent a 50-g 1-h glucose challenge test (GCT) followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT result was ≥7.8 mmol/L. GDM was defined by the International Association of Diabetes and Pregnancy Study Group's cut-points. Univariable and multivariable logistic regression analyses were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) analysis nested in the logistic regression analysis was used to identify a cutoff point of height for GDM. Additive interaction was used to test interactions between short height, pregnancy overweight/obesity and undue weight gain.Results: A total of 1,517 (or 7.6%) women developed GDM. The risk of GDM increased rapidly with a decreasing height from 158 cm and downwards. Using height ≥158 cm as the reference group, women with < 158 cm of height were at increased GDM risk (adjusted OR: 1.44, 95%CI: 1.18–1.75). Maternal overweight/obesity at the first antenatal care visit greatly enhanced the OR of short height for GDM (adjusted OR: 3.78, 95%CI: 2.84–5.03) with significant additive interaction (P < 0.05). However, the interaction between short height and undue weight gain was non-significant (P > 0.05).Conclusions: In Chinese pregnant women in urban Tianjin, height < 158 cm had a synergistic effect with pre-pregnancy overweight/obesity on the risk of GDM.

Current progress in metabolomics of gestational diabetes mellitus

“…Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders of pregnancy and is defined as any degree of carbohydrate intolerance that occurs or is first recognized during pregnancy[ 1 ]. The prevalence of GDM has been rising worldwide, including in China, in the past few decades[ 2 ] and its prevalence ranges from 9.3% to 25.5% worldwide[ 3 ]. GDM can cause short-term and long-term adverse effects in pregnant women, including an increased risk of macrosomia, preterm delivery, preeclampsia, cesarean section, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, type 2 diabetes (T2D), hypertension, metabolic disorders, and even cardiovascular disease[ 4 - 8 ].…”

The Effect of Strict Volume Control Assessed by Repeated Bioimpedance Spectroscopy on Cardiac Function in Peritoneal Dialysis Patients

“…However, traditional approaches, such as cardiothoracic ratio, BP, or brain natriuretic peptide, were not sensitive enough to detect subtle changes in fluid status. Most studies that evaluated the association between fluid overload measured by BIS and echocardiographic parameters in CKD patients were cross-sectional analyses 3,18,19 . Therefore, the effect of overhydration status assessed by BIS measurements on cardiac function over time remains unclear.…”

Gender Differences Between the Phenotype of Short Stature and the Risk of Diabetes Mellitus in Chinese Adults: A Population-Based Cohort Study

“…In a survey and analysis by Conway et al., it was pointed out that there was no significant correlation between height and DM risk in Shanghai population, China, while another data from people in Tianjin Province of China by Li et al. showed that short stature in women was closely related to gestational DM ( 34 , 35 ). In our current study, we analyzed the national physical examination data of Rich Healthcare Group involving 32 locations in 12 cities in China.…”

“…A recent study by Professor Al Ssabbagh from India showed that there seems to be a U-shaped association between women’s height and the risk of DM, in which the height is between 155 and 160 cm and the risk of DM is the lowest ( 33 ). In addition, in a recent study on gestational DM by Li et al., they determined that 158 cm may be the critical point of short stature for Tianjin women to assess the risk of gestational DM ( 35 ). Among men, an Israeli study showed that people with a height of 170–175 cm are at a critical risk of DM ( 39 ).…”