Combined general and central obesity indices to predict gestational diabetes

Figures & data

Figure 1. Flow diagram of study participants. GDM: gestational diabetes mellitus; IGT: impaired glucose tolerance; DM: diabetes mellitus; PCOS: polycystic ovary syndrome; OGTT: oral glucose tolerance test.

Table 1. Demographic and clinical data of pregnant women.

	GDM	Non-GDM
Variable	n = 108	n = 705	p
Age (years)	33(30–36)	31(28–34)	<.001a
Age category (years)			<.001^b
<35	68(63.0%)	579(80.9%)
35–39	36(33.3%)	116(16.5%)
≥40	4(3.7%)	19(2.7%)
Gestational week	12(12–12)	12(12–12)	.316^a
Education level			.729^b
Education ≤12 years	2(1.9%)	21(3.0%)
Education >12 years	106(98.1%)	684(97.0%)
Smoking habit			1.000^b
Never smoked	107(99.1%)	698(99.0%)
Ex-smoker	1(0.9%)	7(1.0%)
Systolic blood pressure (mmHg)	114(108–125)	110(103–118)	.001^a
Diastolic blood pressure (mmHg)	73(65–80)	70(64–77)	.042^a
Number of deliveries			.003^b
0	61(56.5%)	493(69.9%)
1	41(38.0%)	200(28.4%)
2	6(5.6%)	12(1.7%)
Mode of conception			.002^b
Natural conception	93(86.1%)	665(94.3%)
ART	15(13.9%)	40(5.7%)
BMI (kg/m^2)	23.5(21.7–26.3)	21.2(19.5–23.2)	<.001^a
BMI category (kg/m^2)			<.001^b
<18.5	3(2.8%)	76(10.9%)
18.5–23.9	56(52.3%)	497(71.5%)
24.0–27.9	34(31.8%)	103(14.8%)
≥28.0	14(13.1%)	19(2.7%)
WC (cm)	88(83–94)	82(78–88)	<.001^a
WHR	0.94(0.90–0.97)	0.89(0.86–0.92)	<.001^a
WHtR	0.55(0.52–0.59)	0.51(0.48–0.54)	<.001^a

GDM: gestational diabetes mellitus; ART: assisted reproductive technique; BMI: body mass index; WC: waist circumference; WHR: waist-to-hip ratio; WHtR: waist-to-height ratio.

^aMann–Whitney rank-sum test; Mean (25th–75th percentiles).

^bChi-square test.

Table 2. Association between central obesity measures and gestational diabetes.

Central obesity measures	GDM (n)	Non-GDM (n)	Crude OR (95% CI)	Multivariale model 1 OR (95% CI)	Multivariale model 2 OR (95% CI)
WC (cm) (in quartiles)
Quartile 1 (<78.0)	9 (8.3%)	174 (24.7%)	1.00	1.00	1.00
Quartile 2 (78.0–82.9)	14 (13.0%)	190 (27.0%)	1.43 (0.60–3.37)	1.18 (0.49–2.82)	0.80 (0.33–1.97)
Quartile 3 (83.0–88.9)	37 (34.3%)	185 (26.2%)	3.87 (1.81–8.25)	3.10 (1.44–6.71)	1.46 (0.62–3.43)
Quartile 4 (≥89.0)	48 (44.4%)	156 (22.1%)	5.95 (2.83–12.52)	4.45 (2.07–9.57)	1.07 (0.38–3.00)
p for trend			<.001	<.001	.56
WHR (in quartiles)
Quartile 1 (<0.87)	9 (8.3%)	195 (27.7%)	1.00	1.00	1.00
Quartile 2 (0.87–0.89)	15 (13.9%)	184 (26.1%)	1.77 (0.75–4.14)	1.62 (0.69–3.82)	1.54 (0.65–3.66)
Quartile 3 (0.90–0.92)	28 (25.9%)	177 (25.1%)	3.43 (1.57–7.46)	2.98 (1.36–6.55)	2.63 (1.18–5.85)
Quartile 4 (≥0.93)	56 (51.9%)	149 (21.1%)	8.14 (3.90–16.99)	6.61 (3.10–14.10)	4.96 (2.27–10.85)
p for trend			<.001	<.001	<.001
WHtR (in quartiles)
Quartile 1 (<0.49)	9 (8.3%)	194 (27.5%)	1.00	1.00	1.00
Quartile 2 (0.49–0.50)	13 (12.0%)	190 (27.0%)	1.48 (0.62–3.53)	1.25 (0.52–3.03)	1.21 (0.47–3.08)
Quartile 3 (0.51–0.54)	32 (29.6%)	171 (24.3%)	4.03 (1.87–8.69)	3.42 (1.57–7.44)	2.99 (1.26–7.10)
Quartile 4 (≥0.55)	54 (50.0%)	150 (21.3%)	7.76 (3.71–16.22)	6.08 (2.85–12.97)	4.01 (1.57–10.19)
p for trend			<.001	<.001	<.001

OR was calculated by binary logistic regression analysis. Crude: not adjusted for covariables; Multivariale model 1: adjusted for maternal age, number of deliveries, and mode of conception; Multivariale model 2: adjusted for maternal age, number of deliveries, mode of conception, and body mass index. GDM: gestational diabetes mellitus; OR: odds ratios; CI: confidence intervals; WC: waist circumference; WHR: waist-to-hip ratio; WHtR: waist-to-height ratio.

Figure 2. Receiver operating characteristic curve of obesity indices for prediction of gestational diabetes mellitus. BMI: body mass index; WHR: Waist-to-hip ratio.