Combined general and central obesity indices to predict gestational diabetes

Abstract

Objective

To investigate the relationship between general and central obesity in the first trimester of pregnancy and gestational diabetes and its predicted value.

Materials and methods

We recruited 813 women who registered at 6–12 weeks of gestation. Anthropometric measurements were done at the first antenatal visit. At 24–28 weeks of pregnancy, gestational diabetes was diagnosed using the 75 g oral glucose tolerance test. Binary logistic regression was used to determine odds ratios and 95% confidence intervals. The receiver-operating characteristic curve was used to evaluate the ability of obesity indices to predict the risk of gestational diabetes.

Results

Odds ratios (95% confidence intervals) of gestational diabetes across increasing quartiles of waist-to-hip ratio were 1.00, 1.54 (0.65–3.66), 2.63 (1.18–5.85), and 4.96 (2.27–10.85), respectively (p < .001), while those for waist-to-height ratio were 1.00, 1.21 (0.47–3.08), 2.99 (1.26–7.10), and 4.01 (1.57–10.19), respectively (p < .001). Areas under the curve for general and central obesity were similar. However, the area under the curve of body mass index combined with the waist-to-hip ratio was the biggest.

Conclusion

Higher waist-to-hip ratio and waist-to-height ratio in the first trimester of pregnancy are associated with increased risks of gestational diabetes in Chinese women. The combination of body mass index and waist-to-hip ratio in the first trimester of pregnancy is a good predictor for gestational diabetes.

Keywords:

• Gestational diabetes
• waist circumference
• Hip circumference
• Body mass index

Author contributions

Qunying Cai: design, planning, data analysis, and manuscript writing; Shu Shi: design, planning, and manuscript writing; Weiwei Cheng: design; Hong Shen: design and data analysis; Baoying Ye: data collection.

Ethical approval

The study was approved by the institutional Medical Ethics Committee of the International Peace Maternity and Child Health Hospital (approved 8/June/2017, (GKLW)2016-39).

Consent form

All human participants gave written informed consent before the study began.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the National Natural Science Foundation of China [81370727], the Project support the guidance of medicine (Traditional Chinese and Western Medicine) in Shanghai [18411963500], and the Interdisciplinary Program of Shanghai Jiao Tong University [ZH2018ZDA31]. The study funders were not involved in in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.