The relationship between fasting plasma glucose in the first trimester of pregnancy and the incidence of gestational diabetes in Iran

Author(s):  
Homeira Rashidi ◽  
Kamelia Kalantari ◽  
Hajieh Shahbazian ◽  
Sedigheh Nouhjah
Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4220
Author(s):  
Minjia Mo ◽  
Bule Shao ◽  
Xing Xin ◽  
Wenliang Luo ◽  
Shuting Si ◽  
...  

The present prospective study included 2156 women and investigated the effect of gene variants in the vitamin D (VitD) metabolic and glucose pathways and their interaction with VitD levels during pregnancy on gestational diabetes mellitus (GDM). Plasma 25(OH)D concentrations were measured at the first and second trimesters. GDM subtype 1 was defined as those with isolated elevated fasting plasma glucose; GDM subtype 2 were those with isolated elevated postprandial glucose at 1 h and/or 2 h; and GDM subtype 3 were those with both elevated fasting plasma glucose and postprandial glucose. Six Gc isoforms were categorized based on two GC gene variants rs4588 and rs7041, including 1s/1s, 1s/2, 1s/1f, 2/2, 1f/2 and 1f/1f. VDR-rs10783219 and MTNR1B-rs10830962 were associated with increased risks of GDM and GDM subtype 2; interactions between each other as well as with CDKAL1-rs7754840 were observed (Pinteraction < 0.05). Compared with the 1f/1f isoform, the risk of GDM subtype 2 among women with 1f/2, 2/2, 1s/1f, 1s/2 and 1s/1s isoforms and with prepregnancy body mass index ≥24 kg/m2 increased by 5.11, 10.01, 10, 14.23, 19.45 times, respectively. Gene variants in VitD pathway interacts with VitD deficiency at the first trimester on the risk of GDM and GDM subtype 2.


2021 ◽  
Author(s):  
Jia-Ning Tong ◽  
Lin-Lin Wu ◽  
Yi-Xuan Chen ◽  
Xiao-Nian Guan ◽  
Kan Liu ◽  
...  

Abstract Purpose Previous studies have suggested that first-trimester fasting plasma glucose (FPG) is associated with gestational diabetes mellitus (GDM) and is a predictor of GDM. The aim of the present study was to explore whether first-trimester FPG levels can be used as a screening and diagnostic test for GDM in pregnant women. Methods This retrospective study included pregnant women who had their first-trimester FPG recorded at 9-13+6 weeks and underwent screening for GDM using the 2-hour 75 g oral glucose tolerance test (OGTT) between 24th and 28th gestational weeks. The cut-off values were calculated using a receiver operating characteristic (ROC) curve. Results The medical records of 28,030 pregnant women were analysed, and 4,669 (16.66%) of them were diagnosed with GDM. The mean first-trimester FPG was 4.62 ± 0.37 mmol/L. The total trend in the optimal cut-off value of first-trimester FPG in pregnant women was 4.735 mmol/L, with a sensitivity of 49%, a specificity of 67.6% and AUC of 0.608 (95% CI: 0.598-0.617, p༜0.001). Moreover, as the maternal age increased, the optimal cut-off values increased, respectively. The results suggest that first-trimester FPG can be considered a marker for identifying pregnant women with GDM. Conclusion The level of first-trimester FPG increased slightly with maternal age and, as maternal age increased, the optimal cut-off values increased, especially after age 30. The first-trimester FPG should be considered a screening marker when diagnosing GDM in pregnant women.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Ping LI ◽  
Shuo Lin ◽  
Ling Li ◽  
Jinhui Cui ◽  
Shuisheng Zhou ◽  
...  

Objective: To evaluate the usefulness of a fasting plasma glucose (FPG) at the first trimester in predicting gestational diabetes mellitus (GDM) and the association between FPG and adverse pregnancy outcomes. Methods: The levels of FPG in women with singleton pregnancies were measured at 9-13+6 weeks. A two hour 75-g oral glucose tolerance test (OGTT) was completed at 24-28 weeks and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria was used. Adverse pregnancy outcomes were assessed and recorded. Results: Among 2112 pregnant women enrolled in the study, 224 (10.6%) subjects were diagnosed with GDM. The AUC for FPG in predicting GDM was 0.63 (95% CI 0.61- 0.65) and the optimal cutoff value was 4.5 mmol/L (sensitivity 64.29% and specificity 56.45%). Higher first-trimester FPG increased the prevalence of GDM, large for gestational age (LGA) and assisted vaginal delivery and/or cesarean section (all P < 0.05). Conclusion: FPG at first trimester could be used to predict GDM and higher first-trimester FPG was associated with adverse pregnancy outcomes. How to cite this:Li P, Lin S, Li L, Cui J, Zhou S, Fan J. First-trimester fasting plasma glucose as a predictor of gestational diabetes mellitus and the association with adverse pregnancy outcomes. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.216 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Author(s):  
Xiaoli Li ◽  
Guilong Li ◽  
Tiantian Cheng ◽  
Jing Liu ◽  
Guangyao Song ◽  
...  

Abstract BackgroundTriglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance. However, study on the relationship between TyG index and incident diabetes remains limited. This study aimed to investigate the association between TyG index and incident diabetes in a large cohort of Chinese population.MethodsThe present study was a retrospective cohort study using healthy screening programme data in China. A total of 201,298 subjects free of baseline diabetes were included who received a health check with all medical records from 2010 to 2016. TyG index was calculated as Ln[fasting triglyceride level (mg/dl) x fasting plasma glucose (mg/dl)/2]. Diagnosis of diabetes was based on fasting plasma glucose ≥ 7.00 mmol/L and/or self-reported diabetes. Cox proportion-hazard model was used to assess the relationship between TyG index at baseline and the risk of incident diabetes. It should be noted that the data was uploaded to the DATADRYAD website, and we only used this data for secondary analysis.ResultsDuring a mean follow-up of 3.12 years of 201,298 individuals aged ≥ 20 years old, 3389 subjects developed diabetes. After adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, serum creatinine, smoking, drinking and family history of diabetes, multivariate cox hazards regression analysis indicated that TyG index was positive correlation with the risk of developing diabetes in Chinese population (HR, 3.34; 95% CI, 3.11 to 3.60). The risk of incident diabetes increased with increasing TyG index. Subjects with TyG index in the fourth quartile were 6.26 times more likely to develop diabetes than the lowest quartile (P trend < 0.001). Subgroup analysis showed the stronger association was observed in the population with age < 40, BMI (≥ 18.5, < 24 kg/m2), SBP < 140 mmHg or females (all P for interaction < 0.0001).Conclusions TyG index was independently correlated with the increased risk of diabetes in Chinese adults, suggesting that TyG index may be a useful marker for identifying individuals at high risk of developing diabetes.


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