A risk prediction model of gestational diabetes mellitus based on traditional and genetic factors

Figures & data

Figure 1. Flowchart.

Table 1. Basic characteristics of women.

	GDM (n = 1323)	Control (n = 1421)	t/x^2	p
Age (years)	30.5 ± 4.6	27.6 + 4.2	17.262	<.0001
Pre-pregnancy body mass index (kg/m^2)	24.53 ± 3.13	20.32 ± 2.03	42.081	<.0001
Number of pregnancies	2.4 ± 1.5	1.6 ± 1.4	14.451	<.001
Family history of diabetes mellitus (%)			91.933	<.001
Yes	324 (24.5%)	151 (10.6%)
No	999 (75.5%)	1270 (89.4%)
History of arterial hypertension (%)			64.853	<.001
Yes	247 (18.7%)	117 (8.2%)
No	1076 (81.3%)	1304 (91.8%)
History of GDM (%)			129.509	<.001
Yes	329 (24.9%)	124 (8.7%)
No	994 (75.1%)	1297 (91.3%)
History of impaired glucose tolerance (%)			94.098	<.001
Yes	348 (26.3%)	168 (11.8%)
No	975 (73.7%)	1253 (88.2%)
Smoking			13.149	1
Yes	66 (5.0%)	34 (2.4%)
No	1257 (95%)	1387 (97.6%)
Drinking			7.575	1
Yes	163 (12.3%)	129 (9.1%)
No	1160 (87.7%)	1292 (90.9%)
Education background			2.772	.096
University or above	1087 (82.2%)	1202 (84.6%)
Junior college or below	235 (17.8%)	219 (15.4%)
Occupation			2.013	.099
Worker	78 (5.86%)	86 (6.03%)
Farmer	6 (0.47%)	6 (0.43%)
Staff general	427 (32.31%)	462 (32.52%)
Professional and technical personnel	60 (4.5%)	68 (4.78%)
Freelance	286 (21.58%)	334 (23.55%)
Unemployed/underemployed	335 (25.36%)	322 (22.69%)
Others	131 (9.92%)	143 (10.08%)
Laboratory parameter
Systolic blood pressure (mmHg)	117.8 ± 10.3	114.2 ± 11.8	8.488	<.01
Diastolic blood pressure (mmHg)	75.6 ± 8.7	70.2 ± 8.0	16.938	<.01
Fasting plasma glucose (mmol/L)	5.1 ± 0.4	4.4 ± 0.5	40.310	<.01
1-h postload glucose (mmol/L)	9.5 ± 1.2	7.0 ± 1.3	52.233	<.01
2-h postload glucose (mmol/L)	8.5 ± 1.5	5.3 ± 1.4	57.802	<.01
Cholesterol (mmol/L)	4.52 ± 0.81	4.46 ± 0.74	2.028	.022
Triglyceride (mmol/L)	1.30 (0.91–1.63)	1.02 (0.85–1.26)		.023
High-density lipoprotein (mmol/L)	1.48 ± 0.26	1.48 ± 0.29	0.000	1
Low-density lipoprotein (mmol/L)	2.13 ± 0.4	2.01 ± 0.35	8.377	<.001
Insulin (mIU/L)	14.5 ± 9.8	9.9 ± 6.5	14.582	<.01

GDM: gestational diabetes mellitus.

Table 2. Multivariate logistic regression analysis results.

	β	Standard error	Wald	Odds ratio	95% confidence interval	p
Age ≥ 30 years	0.085	0.021	16.484	1.089	1.003–1.032	<.001
Family history of diabetes mellitus	0.440	0.134	10.791	1.553	1.032–4.315	.006
History of gestational diabetes mellitus (%)	0.878	0.284	9.557	2.406	1.497–6.022	.018
History of impaired glucose tolerance (%)	0.179	0.068	6.928	1.196	1.094–2.286	.013
Systolic blood pressure ≥116.22 mmHg	0.290	0.102	8.066	1.336	1.264–1.827	<.001
Diastolic blood pressure ≥74.52 mmHg	0.712	0.135	27.813	2.038	1.243–3.109	<.001
Fasting plasma glucose ≥5.0 mmol/L	0.329	0.094	12.219	1.389	1.024–4.143	<.001
1-h postload glucose ≥8.8 mmol/L	0.310	0.132	5.530	1.364	1.166–2.258	.006
2-h postload glucose ≥7.9 mmol/L	0.423	0.104	16.516	1.526	1.023–2.051	.003
Cholesterol ≥4.50 mmol/L	0.492	0.112	19.269	1.635	1.261–2.614	.001
Low-density lipoprotein ≥2.09 mmol/L	0.281	0.087	10.463	1.325	1.133–2.314	.002
Insulin ≥11.5 mIU/L	0.310	0.125	6.167	1.364	1.151–2.528	.001

Table 3. Strength of association between SNPs and postpartum diabetes mellitus among women with gestational diabetes mellitus history.

SNP	Allelic gene	RAF		Allelic risk		r	E	Vi	Pvi
		Non-patient	Patient	Odds ratio	95% confidence interval
rs10906115	A/G	0.355	0.462	1.596	0.823–1.635	0.125	0.125	0.001	0.015
rs10886471	C/T	0.715	0.930	1.859	2.359–1.945	0.141	0.133	0.001	0.025
rs2779116	T/C	0.444	0.577	1.154	1.654–1.865	0.133	0.154	0.002	0.057
rs10946398	A/C	0.221	0.287	1.575	1.075–1.697	0.154	0.161	0.002	0.087
rs7612463	C/A	0.301	0.391	1.284	1.283–1.964	0.147	0.054	0.001	0.095
rs7034200	A/C	0.236	0.307	1.236	1.114–2.136	0.102	0.134	0.002	0.042
rs17271305	A/G	0.434	0.564	1.128	1.628–2.015	0.141	0.128	0.001	0.064
rs7944584	A/T	0.646	0.840	1.680	2.180–1.964	0.125	0.157	0.006	0.095
rs780094	A/G	0.291	0.378	1.757	1.257–1.889	−0.142	0.134	0.002	0.022
rs7041847	A/G	0.264	0.343	1.686	1.186–1.965	0.154	0.051	0.005	0.092
rs1402837	T/C	0.361	0.469	1.939	1.439–2.151	0.153	0.062	0.001	0.089
rs5215	C/T	0.474	0.616	1.232	1.732–2.165	0.152	0.124	0.006	0.095
rs1046896	C/T	0.111	0.144	1.289	0.789–2.001	0.102	0.134	0.001	0.086
rs11605924	A/C	0.361	0.469	1.539	1.439–2.361	0.136	0.121	0.001	0.094
rs560887	T/C	0.532	0.692	1.383	1.883–2.154	0.154	0.134	0.004	0.086
rs6815464	C/G	0.625	0.813	1.225	1.125–1.964	0.124	0.058	0.001	0.092
rs5015480	C/T	0.545	0.709	0.917	1.917–1.954	0.125	0.096	0.001	0.099
rs6467136	G/A	0.345	0.449	1.497	1.397–1.933	0.104	0.014	0.002	0.002
rss7072268	C/T	0.754	0.980	1.461	1.460–1.951	0.147	0.115	0.003	0.006
rs895636	C/T	0.446	0.580	1.160	1.660–1.972	0.134	0.134	0.001	0.002
rs7172432	A/G	0.210	0.273	1.246	1.046–1.989	0.104	0.124	0.002	0.013
rs10811661	T/C	0.346	0.450	0.900	0.800–2.154	0.128	0.117	0.006	0.018
rs11212617	A/C	0.296	0.385	1.360	1.270–2.614	0.136	0.102	0.002	0.017
rs6017317	G/T	0.477	0.620	1.240	1.140–2.314	0.104	0.157	0.002	0.015
rs2191349	T/G	0.654	0.850	1.269	1.200–2.154	0.122	0.138	0.001	0.009
rs4737009	A/G	0.286	0.372	1.246	1.244–2.624	0.164	0.134	0.005	0.006
rs2283228	A/C	0.265	0.345	1.289	1.189–2.165	0.117	0.161	0.002	0.011
rs831571	C/T	0.361	0.469	1.439	1.430–2.314	0.102	0.115	0.001	0.015
rs7403531	C/T	0.455	0.592	1.283	1.183–2.524	−0.152	0.134	0.006	0.013
rs10830963	C/G	0.155	0.202	1.403	0.903–1.685	−0.141	0.134	0.002	0.012
rs4607517	A/G	0.364	0.473	1.946	1.446–1.984	−0.150	0.115	0.001	0.018
rs11185790	A/G	0.514	0.268	2.336	1.836–2.685	0.124	0.104	0.001	0.069
rs11558471	A/G	0.395	0.504	2.807	2.307–3.074	0.143	0.341	0.002	0.012
rs174550	T/C	0.545	0.309	2.417	1.917–2.694	0.124	0.136	0.001	0.022
rs35767	G/A	0.555	0.322	2.443	1.943–2.954	0.115	0.214	0.001	0.027
rs13266634	C/T	0.356	0.463	1.926	1.426–2.851	0.161	0.158	0.002	0.006
rs7901695	C/T	0.454	0.590	2.180	1.680–2.958	0.134	0.125	0.006	0.041
rs11071657	A/G	0.452	0.588	2.175	1.675–2.957	0.121	0.214	0.002	0.014
rs730497	G/A	0.345	0.449	1.897	1.397–2.557	0.151	0.164	0.004	0.001
rs9470794	C/T	0.545	0.709	2.417	1.917–2.987	0.113	0.118	0.006	0.001

SNP: Single nucleotide polymorphism.

Figure 2. Bayesian model with incorporation of traditional and genetic factors for predicting GDM. BP: blood pressure; CHOL: cholesterol; GDM: gestational diabetes mellitus; IGT: impaired glucose tolerance; LDL: low-density lipoprotein. rs2779116, rs5215, rs11605924, rs7072268, rs7172432, rs10811661, rs2191349, rs10830963, rs174550, rs13266634 and rs11071657 are SNP loci.

Figure 3. Receiver operating characteristic curves of the model. (A) Internal evaluation; (B) external validation.

Figure 4. Calibration curves of the model. (A) Internal evaluation; (B) external validation.

Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.