High waist circumference, triglycerides in early pregnancy predict GDM
MedWire News: A large waist circumference and high triglycerides in the first trimester of pregnancy predict glucose intolerance or gestational diabetes mellitus (GDM) in later pregnancy, report Canadian researchers.
Currently, tools used to diagnose GDM, most commonly the fasting oral glucose tolerance test, are time-consuming, expensive, and uncomfortable for pregnant women and only allow diagnosis at the end of the second trimester.
Diane Brisson (University of Montréal, Quebec) and fellow researchers investigated whether the "hypertriglyceridemic waist" phenotype of high triglycerides (1.70 mmol/l; 150.60 mg/dl or above) and a large waist circumference (greater than 85 cm) at 11-14 weeks of pregnancy predicted GDM or glucose intolerance at 24-28 weeks of pregnancy. A 75 g oral glucose tolerance test was performed at the later stage to measure glucose intolerance.
The team recruited a total of 144 White pregnant women to take part in the study. The women were aged 28.3 years on average, had a mean waist circumference of 87.6 cm, a mean triglyceride level of 1.16 mmol/l (102.74 mg/dl), and 13.2% had prior GDM.
Brisson and colleagues found that women who had the hypertriglyceridemic waist phenotype in early pregnancy had a significant 6.1-fold increased risk for having a fasting glucose level of 7.8 mmol/l or above (World Health Organization cutoff point for gestational glucose intolerance) in later pregnancy.
This association was slightly weakened (4.7-fold risk increase), but remained significant even after correcting for maternal age, fasting glucose level in the first trimester of pregnancy, and a previous history of GDM.
"Our results have yet to be replicated in larger samples and diversified populations, or with various ranges of gestational glucose intolerance," caution the authors.
They conclude: "Further research is needed to identify optimal waist girth and plasma triglyceride cut points for this population and to evaluate the hypertriglyceridemic-waist phenotype as a potential screening or diagnostic test."
The results of the study are published in the Canadian Medical Association Journal.
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By Helen Albert