scholarly journals A Novel Nomogram for Predicting Gestational Diabetes Mellitus During Early Pregnancy

2021 ◽  
Vol 12 ◽  
Author(s):  
Mei Kang ◽  
Hui Zhang ◽  
Jia Zhang ◽  
Kaifeng Huang ◽  
Jinyan Zhao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Predictive Model ◽  
B Lymphocytes ◽  
Early Pregnancy ◽  
Characteristic Curve ◽  
Patient Counseling ◽  
Calibration Curves

ObjectiveGestational diabetes mellitus (GDM) is a serious threat to maternal and child health. However, there isn’t a standard predictive model for the disorder in early pregnancy. This study is to investigate the association of blood indexes with GDM and establishes a practical predictive model in early pregnancy for GDM.MethodsThis is a prospective cohort study enrolling 413 pregnant women in the department of Obstetrics and Gynecology in Shanghai General Hospital from July 2020 to April 2021.A total of 116pregnantwomen were diagnosed with GDM during the follow-up. Blood samples were collected at early trimester (gestational weeks 12-16) and second trimester(gestational weeks 24-26 weeks). A predictive nomogram was established based on results of the multivariate logistic model and 5-fold cross validation. We evaluate the nomogram by the area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCAs).ResultsSignificant differences were observed between the GDM and normal controls among age, pre-pregnancy BMI, whether the pregnant women with complications, the percentage of B lymphocytes, fasting plasma glucose (FPG), HbA1c, triglyceride and the level of progesterone in early trimester. Risk factors used in nomogram included age, pre-pregnancy BMI, FPG, HbA1c, the level of IgA, the level of triglyceride, the percentage of B lymphocytes, the level of progesterone and TPOAb in early pregnancy. The AUC value was 0.772, 95%CI (0.602,0.942). The calibration curves for the probability of GDM demonstrated acceptable agreement between the predicted outcomes by the nomogram and the observed values. DCA curves showed good positive net benefits in the predictive model.ConclusionsA novel predictive nomogram was developed for GDM in our study, which could do help to patient counseling and management during early pregnancy in clinical practice.

scholarly journals Skipping breakfast before and during early pregnancy and incidence of gestational diabetes mellitus: the Japan Environment and Children's Study

2020 ◽  
Vol 111 (4) ◽  
pp. 829-834 ◽  
Author(s):  
Jia-Yi Dong ◽  
Satoyo Ikehara ◽  
Takashi Kimura ◽  
Meishan Cui ◽  
Yoko Kawanishi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Dietary Habits ◽  
Daily Consumption ◽  
Breakfast Consumption ◽  
Prepregnancy Bmi ◽  
Study Enrollment

ABSTRACT Background There is little evidence linking breakfast skipping to the incidence of gestational diabetes mellitus (GDM). Objectives We aimed to evaluate the prospective association of breakfast consumption with the incidence of GDM. Methods A total of 103,099 pregnancies were registered during study enrollment (January 2011 to March 2014), involving 97,454 pregnant women from 15 areas across Japan. Singleton pregnant women free of GDM, stroke, heart disease, cancer, and type 1 or type 2 diabetes at the study enrollment were eligible for analysis. We used a self-administered questionnaire to obtain data on demographic information, socioeconomic status, self-rated health status, disease history, lifestyle, and dietary habits of each woman at study enrollment. A semiquantitative FFQ was used for dietary assessment. We used logistic regression to obtain the OR of GDM in relation to breakfast consumption. Results Among 84,669 pregnant women for analysis, 1935 cases of GDM were documented. After adjustment for potential confounding factors including prepregnancy BMI, the multivariable-adjusted ORs of GDM for women who consumed breakfast 5–6 times/wk, 3–4 times/wk, and 0–2 times/wk were 1.09 (95% CI: 0.93, 1.27), 1.14 (95% CI: 0.96, 1.34), and 1.21 (95% CI: 1.05, 1.41), respectively, compared with daily breakfast eaters. The association appeared to be dose dependent (P-trend = 0.006) and was not significantly modified by prepregnancy BMI. Conclusions Breakfast consumption <3 times/wk before and during early pregnancy, compared with daily consumption, was associated with an increased odds of developing GDM.

scholarly journals Dynamic thiol/disulfide homeostasis in gestational diabetes mellitus: Is it related with adverse perinatal outcomes?

2019 ◽  
Vol 6 (9) ◽  
pp. 198-204 ◽  
Author(s):  
Beril Gürlek ◽  
Murat Alan ◽  
Sabri Çolak ◽  
Özgür Önal ◽  
Özcan Erel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Characteristic Curve ◽  
Perinatal Outcomes ◽  
Oral Glucose ◽  
Total Thiol ◽  
Adverse Perinatal Outcomes

Objective: Aims of the study is to specify the significance of thiol/disulfide homeostasis in the aspect of gestational diabetes mellitus (GDM) and GDM-related complications. Material and Methods: This study is a prospective review of the data of 61 healthy and non-pregnant women, 58 healthy pregnant women, and 62 pregnant women with GDM. Results: The patients with gestational diabetes mellitus had significantly higher disulfide/native thiol and disulfide/total thiol concentrations than non-pregnant patients (p<0.001 for both) and healthy pregnant patients (p: 0.015 and p: 0.018, respectively). Besides, in GDM group had significantly lower native thiol/total thiol concentrations than non-pregnant patients and healthy pregnant patients (p<0.001 and p: 0.016, respectively). There were positive and significant correlations between disulfide levels and HbA1c concentrations (r=0.26, p: 0.042), and between disulfide and oral glucose tolerance test first hour concentrations (r=0.26, p: 0.039). The receiver operating characteristic curve analyses for native thiol, total thiol, and disulfide were unable to predict adverse perinatal outcomes in this cohort. Conclusion: The significantly higher concentrations of disulfide/native thiol and disulfide/total thiol in women with GDM could be considered as the presence of increased oxidative stress.  However, these markers failed to predict adverse perinatal outcomes. Keywords: gestational diabetes mellitus; oxidative stress; perinatal outcome; pregnancy; thiol/disulfide homeostasis

scholarly journals Visceral fat mass as a novel risk factor for predicting gestational diabetes in obese pregnant women

2018 ◽  
Vol 11 (3) ◽  
pp. 121-125 ◽  
Author(s):  
J Balani ◽  
SL Hyer ◽  
H Shehata ◽  
F Mohareb
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Decision Tree ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Predictive Model ◽  
Fat Mass ◽  
Visceral Fat ◽  
Composition Analysis

Objective To develop a model to predict gestational diabetes mellitus incorporating classical and a novel risk factor, visceral fat mass. Methods Three hundred two obese non-diabetic pregnant women underwent body composition analysis at booking by bioimpedance analysis. Of this cohort, 72 (24%) developed gestational diabetes mellitus. Principal component analysis was initially performed to identify possible clustering of the gestational diabetes mellitus and non-GDM groups. A machine learning algorithm was then applied to develop a GDM predictive model utilising random forest and decision tree modelling. Results The predictive model was trained on 227 samples and validated using an independent testing subset of 75 samples where the model achieved a validation prediction accuracy of 77.53%. According to the decision tree developed, visceral fat mass emerged as the most important variable in determining the risk of gestational diabetes mellitus. Conclusions We present a model incorporating visceral fat mass, which is a novel risk factor in predicting gestational diabetes mellitus in obese pregnant women.

scholarly journals Body Mass Index and Blood Lipids Underpin The Correlation Between The Age At Menarche and Gestational Diabetes Mellitus

2021 ◽  
Author(s):  
Dongjian Yang ◽  
Ya Yang ◽  
Jingjin Shi ◽  
Xiaoyue Cheng ◽  
Lei Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Blood Lipids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Age At Menarche

Abstract Background The age of menarche affects the metabolic activities in pregnant women. However, data on the factors that define the association between age at menarche and gestational diabetes mellitus (GDM) remains scant. Methods Logistic regression models coupled with restricted cubic splines were used to analyze the effect of menarche on GDM. We stratified the participants by age at pregnancy, fetal gender, and parity. We interrogated the role of BMI before pregnancy, BMI gain during pregnancy, and blood lipids in early pregnancy in mediating GDM. Results With menarche age ≤ 12 years as the control, women with menarche ages of 13, 14, and ≥ 15 years had 0.91 (95%CI, 0.85 to 0.97), 0.87 (95%CI, 0.81 to 0.93), and 0.85 (95%CI, 0.79 to 0.91) odds ratio for GDM. There were similar and pronounced effects in advanced-age pregnancy, with male fetuses and primiparous women. We showed that pre-pregnancy BMI and blood lipids such as triglycerides, total cholesterol, and low-density lipoprotein in early pregnancy mediate the association between age at menarche and GDM. Conclusion Taken together, our data demonstrated that menarche at early ages fuels the development of GDM. For pregnant women with early menarche should reduce BMI and blood lipid levels before pregnancy.

scholarly journals B Lymphocytes Are Predictors of Insulin Resistance in Women with Gestational Diabetes Mellitus

2019 ◽  
Vol 19 (3) ◽  
pp. 358-366 ◽  
Author(s):  
Yan Zhuang ◽  
Jin Zhang ◽  
Yiwei Li ◽  
Hongqin Gu ◽  
Jinyan Zhao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
B Lymphocytes ◽  
Immune Cells ◽  
Roc Curves ◽  
Cutoff Point ◽  
Optimal Cutoff Point

Backgroud: The present study aimed to investigate the association between immune cells and gestational diabetes mellitus (GDM) and identify a reasonable predictor of insulin resistance in women with GDM. Objective: The clinical and biochemical characteristics of 124 women with GDM and 168 healthy pregnant women were compared. Methods: The percentage of immune cells in the blood of the subjects was analyzed by flow cytometry. Pearson’s correlation analysis revealed the correlation between the percentage of B lymphocytes and insulin resistance. A cutoff point was determined for the percentage of B lymphocytes, based on insulin resistance, using receiver operating characteristic (ROC) curves. Results: Compared to the healthy pregnant women, the percentages of B lymphocytes and IgA produced by B-cells were significantly different in women with GDM. The percentage of B lymphocytes was positively related to insulin resistance.The number of 14.05% of B lymphocytes was an optimal cutoff point that predicted the insulin resistance in women with GDM. Conclusion: The percentage of B lymphocytes was positively associated with insulin resistance, and hence, might serve as an appropriate predictor of insulin resistance in women with GDM.

Circulating fatty acids and risk of gestational diabetes mellitus: prospective analyses in China

2021 ◽  
Author(s):  
Xiong-Fei Pan ◽  
Yichao Huang ◽  
Xinping Li ◽  
Yi Wang ◽  
Yi Ye ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Fatty Acids ◽  
Standard Deviation ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Central China ◽  
Western China ◽  
Standard Deviation Increase

Objective We aimed to examine prospective associations between circulating fatty acids in early pregnancy and incident gestational diabetes mellitus (GDM) among Chinese pregnant women. Methods Analyses were based on two prospective nested case-control studies conducted in western China (336 GDM cases and 672 matched controls) and central China (305 cases and 305 matched controls). Fasting plasma fatty acids in early pregnancy (gestational age at enrollment: 10.4 weeks [standard deviation, 2.0]) and 13.2 weeks [1.0], respectively) were determined by gas chromatography-mass spectrometry, and GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Groups criteria during 24-28 weeks of gestation. Multiple metabolic biomarkers (HOMA-IR [homeostatic model assessment for insulin resistance], HbA1c, c-peptide, high-sensitivity C-reactive protein, adiponectin, leptin, and blood lipids) were additionally measured among 672 non-GDM controls at enrollment. Results Higher levels of saturated fatty acids (SFAs) 14:0 (pooled odds ratio, 1.41 for each 1-standard deviation increase; 95% confidence interval, 1.25, 1.59) and 16:0 (1.19; 1.05, 1.35) were associated with higher odds of GDM. Higher levels of n-6 polyunsaturated fatty acid (PUFA) 18:2n-6 was strongly associated with lower odds of GDM (0.69; 0.60, 0.80). In non-GDM pregnant women, higher SFAs 14:0 and 16:0 but lower n-6 PUFA 18:2n-6 were generally correlated with unfavorable metabolic profiles. Conclusions We documented adverse associations of 14:0 and 16:0 but a protective association of 18:2n-6 with GDM among Chinese pregnant women. Our findings highlight the distinct roles of specific fatty acids in the onset of GDM.

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