scholarly journals The interactive effects of pre-pregnancy body mass index, thyroid function, and blood lipid levels on the risk of gestational diabetes mellitus: a crossover analysis

Author(s):  
Ying Wang ◽  
Sha Lu ◽  
Xianrong Xu ◽  
Lijun Zhang ◽  
Jun Yang ◽  
...  

Abstract Background Studies have demonstrated the associations between pre-pregnancy obesity, thyroid dysfunction, dyslipidemia, and increased risk of gestational diabetes mellitus (GDM) in pregnant women. This study was designed to investigate whether and to what extent, the interactions between these factors contribute to the risk of GDM. Methods A case-control study of 232 GDM cases and 696 controls was conducted among pregnant women from Hangzhou, China. Multiple logistic regression analysis was applied to identify independent risk factors of GDM. Crossover analysis was performed to assess the interactive effects of pre-pregnancy body mass index (pBMI), thyroid hormones, blood lipid profiles on the risk of GDM. The indexes including attributable proportion (AP) to the interaction and the relative excess risk due to interaction (RERI) were calculated. Results Chinese pregnant women with pBMI > 23 kg/m2 (adjusted: OR=4.162, P<0.001), high triglyceride levels (> 2.30 mmol/L) (adjusted: OR=1.735, P<0.001) and the free triiodothyronine/free thyroxine (FT3/FT4) ratio ≥0.502 (OR=4.162, P<0.001) have significantly increased risk of GDM. Crossover analysis indicated that there were significant interactions between pre-pregnancy overweight/obesity and FT3/FT4 ≥0.502(AP=0.550, P<0.001; RERI=7.586, P=0.009), high TG levels and FT3/FT4≥0.502 (AP=0.348, 95%CI=0.081~0.614, P=0.010; RERI =2.021, 95%CI=0.064~3.978, P=0.043) on the risk of GDM. Conclusion The interactions between pBMI and FT3/FT4 ratio, TG level, and FT3/FT4 ratio may have significant impacts on the risk of GDM in pregnant women. Such findings may help improve our understanding of the pathogenesis of GDM as well as develop comprehensive strategies for the management of GDM.

2018 ◽  
Author(s):  
George Simeakis ◽  
Evangelia Vogiatzi ◽  
Panagiota Konstantakou ◽  
Evangelia Zapanti ◽  
Katerina Saltiki ◽  
...  

2015 ◽  
Vol 7 (S1) ◽  
Author(s):  
Renata Selbach Pons ◽  
Fernanda Camboim Rockett ◽  
Bibiana de Almeida Rubin ◽  
Maria Lúcia Rocha Oppermann ◽  
Vera Lúcia Bosa

2015 ◽  
Vol 64 (5) ◽  
pp. 87-95 ◽  
Author(s):  
Roman Victorovich Kapustin ◽  
Ol’ga Nikolaevna Arzhanova ◽  
Olesya Nikolaevna Bespalova ◽  
Vladimir Stepanovich Pakin ◽  
Andrey Gennadievich Kiselev

Objective: on the basis of a systematic review, clarify the role of overweight and obesity as a predictor of gestational diabetes mellitus (GDM). Materials and methods: an analysis of the literature data of the leading bibliographic sources - MEDLINE, Cochrane col., EMBASE. To evaluate the body mass index and standards of weight gain during pregnancy used the WHO guidelines and criteria of the Institute of Medicine (2009). The frequency and the odds ratio (OR) of developing GDM was estimated separately for each of the three groups in BMI. Results: A systematic review included 23 different design studies involving 740 510 women. It was found that the odds ratio of the risk of GDM in a group of pregnant women with excess weight is doubled - 2.22 (95 % CI 1.72 - 3.64), and almost four in obesity - 3.88 (95 % CI 2.97 - 5.32). The incidence of GDM in a group of pregnant women with normal body mass index - 3.77 % in the group with excess body weight - 6.59 %, in the group with obesity - 9.88 %. Conclusions: The obtained strong evidence of a direct connection between the linear increase in maternal BMI and the risk of developing gestational diabetes. Pregnant women with excess weight and obesity are at high risk for carbohydrate disorders during pregnancy.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1746
Author(s):  
Elrazi A. Ali ◽  
Hala Abdullahi ◽  
Duria A. Rayis ◽  
Ishag Adam ◽  
Mohamed F. Lutfi

Background: The exact influences of thyroid functions on body mass index (BMI) are ill-defined in euthyroid pregnant women with gestational diabetes mellitus (GDM). Objectives: To investigate the effect of GDM on maternal thyroid functions and BMI. Methods:  A case- control study was conducted in Saad Abualila Hospital, Khartoum, Sudan June to August 2015. Cases included women with GDM and healthy pregnant women as controls. Thyroid hormones [thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), and free thyroxine (FT4)] and anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured. Results:  BMI was significantly increased in GDM patients (26.3 (2.7) Kg/m2) compared with the control group (24.3(1.8) Kg/m2, P = 0.001). Levels of FT3 and FT4 were significantly decreased in GDM patients (0.632 (0.408 ─ 1.074) pg/ml; 0.672 (0.614 ─ 0.960) ng/dl) compared with the healthy pregnant women (0.820 (0.510─1.385) pg/ml, P = 0.021; 0.840 (0.767─1.200) ng/dl, P < 0.001). In contrast, anti-TPO and anti-TG were significantly higher in GDM patients (11.13 (7.969 ─13.090) IU/ml; 14.40 (10.91─20.69) IU/ml) compared with the control group (8.90 (6.375─10.48 IU/ml, P = 0.022; 10.50 (8.2─13.95) IU/ml, P = 0.010). BMI correlated negatively with FT3 (r = ─ 0. 375, P = 0.002) and FT4 (r = ─ 0. 316, P = 0.009) and positively with anti-TPO (r = 0.361, P = 0.002) and anti-TG (r = 0.393, P = 0.010). Conclusion: The present results add further evidence for decreased free thyroid hormones, increased anti-thyroid autoantibodies and higher BMI in patients with GDM compared to healthy pregnant women. BMI correlated directly with FT3 and FT4, but failed to demonstrate significant association with TSH.


2017 ◽  
Vol 145 (5-6) ◽  
pp. 275-279 ◽  
Author(s):  
Vesna Rudic-Grujic ◽  
Milkica Grabez ◽  
Stela Stojisavljevic ◽  
Budimka Novakovic ◽  
Snjezana Popovic-Pejicic

Introduction/Objective. Not only do pre-pregnancy overweight or obesity increase the risk of adverse maternal and perinatal outcomes but they also lead to the development of gestational diabetes mellitus. The objective of this study was to estimate the prevalence of pre-pregnancy overweight and obesity in the Republic of Srpska and to investigate its association with hyperglycemia and risk of gestational diabetes mellitus. Methods. A cross-sectional study was carried out during the period from February to October 2012 among 555 pregnant women in gestational period from 24 to 28 weeks. The criterion for exclusion from the sample was previously diagnosed type 1 or type 2 diabetes. Results. Before pregnancy, 20.39% of participants had increased body mass index, while 4.04 % [95% confidence interval (CI); 2.62?6.13] were obese. Gestational diabetes mellitus was diagnosed in 10.91% (95% CI, 8.44?13.98) of them. The increase in body mass index by 1 increased the risk of gestational diabetes mellitus by 1.09 times [odds ratio (OR) = 1.09; 95% CI; 1.02?1.16]. Pregnant women who were overweight had a 4.88 times greater risk (OR = 4.88; 95% CI, 1.23?29.41) of developing gestational diabetes. Conclusion. Every fifth pregnant woman in this study was overweight or obese before pregnancy. The increase in body mass index by 1 increased the risk of gestational diabetes by 1.09 times (OR = 1.09; 95% CI; 1.02?1.16). Counselling is necessary for overweight and obese women planning pregnancy.


2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.


2020 ◽  
Vol 7 (2) ◽  
pp. 218
Author(s):  
Sambit Das ◽  
Mahesh Rath ◽  
Lipsa Das ◽  
Kasturi Bharadwaj

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ≥92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ≥92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.


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