The Relationship Between Different Obesity Indexes And Gestational Diabetes Mellitus In Early Pregnancy

Objectives:To investigate the relationship of both the general obesity index(body mass index,BMI)with the central obesity index(waist-to-height ratio,WHt R)and gestational diabetes(GDM)in pregnant women during the early pregnancy.Content:From January to July 2018,531 pregnant women of the clinic for early pregnancy of the International Peace Maternal&Child Health Hospital affiliated to Shanghai Jiao Tong University of Medicine were selected as research objects.Pregnant women were divided into normal group(BMI<24 kg/m~2,WHt R<0.5)and overweight group(BMI≥24 kg/m~2,WHt R≥0.5).Oral glucose tolerance test(OGTT)should be conducted by all participates at 24-28 weeks of pregnancy.Methods:1.Pregnant women were divided into normal group and overweight group to compare the difference of GDM incidence between two groups.2.Receiver operating characteristics(ROC)was used to analyze the value of BMI and WHt R in predicting GDM,and to determine the optimal cut-off value of BMI and WHt R in the diagnosis of GDM.Pregnant women were divided into normal group and subclinical overweight group with the cut-off value to compare the difference of GDM incidence between two groups.3.Logistic regression was used to analyze the risk factors of GDM.Results:1.The incidence of GDM in the overweight group was higher than that in the normal group.Only using BMI as the overweight criterion,the GDM incidence in two groups was 16.8%and 7.7%,respectively.And only using WHt R as the overweight criterion,the GDM incidence in two groups was 12.1%and 5.7%,respectively.2.ROC curve analysis demonstrated that the value of WHt R was similar to that of BMI in predicting GDM(AUC 0.626(WHt R)/0.599(BMI),P=0.22).Compared with the value of using only one obesity index,the value of combining two obesity indexes in predicting GDM has no advantage(AUC 0.613).3.The optimal cut-off value of BMI and WHt R in predicting GDM was 22.25kg/m~2 and 0.5171,respectively.When the optimal cut-off values of BMI and WHt R were used as the diagnostic criteria for subclinical overweight,the incidence ofGDM in the subclinical overweight group was higher than that in the normal group.Only using BMI as the subclinical overweight criterion,the GDM incidence in two groups was 14.9%and 6.1%,respectively.And only using WHt R as the subclinical overweight criterion,the GDM incidence in two groups was 14.4%and 6.0%,respectively.4.Logistic regression analysis showed that subclinical overweight women in early pregnancy(BMI≥22.25 kg/m~2,WHt R≥0.517),high triglycerides and family history of diabetes were independent risk factors for GDM.Conclusion:1.High BMI and WHt R of women in early pregnancy were risk factors for GDM.2.Subclinical overweight women(BMI≥22.25 kg/m~2,WHt R≥0.517)in early pregnancy,high triglycerides and family history of diabetes were independent risk factors for GDM.3.The AUC of BMI,WHt R and combining two obesity indexes in predicting GDM were 0.599,0.626 and 0.613,respectively.The value of WHt R wassimilar to that of BMI in predicting GDM(P>0.05).Compared with using only one obesity index,combining two obesity indexes did not improve the predicted value of GDM.