Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus
-
Mehmet Sukru Budak
,
Sedat Akgol
Abstract
Background
To date, only a limited number of studies have evaluated the importance of abdominal subcutaneous fat thickness (ASFT) on gestational diabetes mellitus (GDM) screening. The aim of this study was to investigate the effectiveness of ASFT measurement during routine obstetric ultrasound performed between 24 and 28 weeks of gestation in predicting cases with GDM.
Methods
This prospective comparative study was conducted on 50 cases with GDM and 50 cases without GDM in the GDM screening program at 24–28 gestational weeks between January 2018 and May 2018. The most accurate ASFT cut-off point values were determined for the prediction of cases with GDM by performing receiver operator characteristic (ROC) curve analysis.
Results
The ASFT was higher in those with GDM compared to those without GDM (P < 0.05). For an ASFT cut-off point value of 18.1 mm for the prediction of cases with GDM, the sensitivity, specificity, negative and positive predictive values were 72.0%, 60.0%, 64.2% and 68.1%, respectively. The risk of GDM increased 3.86-fold in those with ASFT level >18.1 mm (P = 0.001).
Conclusion
The ASFT value measured by routine obstetric ultrasound performed at 24–28 weeks of gestation was found to be significantly higher in patients with GDM in comparison to those without GDM. However, further multi-centered and comprehensive prospective studies are required to better demonstrate this relationship.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Jang HC. Gestational diabetes in Korea: incidence and risk factors of diabetes in women with previous gestational diabetes. Diabetes Metab J 2011;35:1–7.10.4093/dmj.2011.35.1.1Search in Google Scholar PubMed PubMed Central
2. Budak MŞ, Araç E. Maternal hypoglycaemia on the 50 g oral glucose challenge test – evaluation of obstetric and neonatal outcomes. Ginekol Pol 2018;89:370–4.10.5603/GP.a2018.0063Search in Google Scholar PubMed
3. Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract 2005;69:279–86.10.1016/j.diabres.2005.01.011Search in Google Scholar PubMed
4. Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007;30:2070–6.10.2337/dc06-2559aSearch in Google Scholar PubMed
5. Pons R, Rockett F, de Almeida Rubin B, Oppermann M, Bosa V. Risk factors for gestational diabetes mellitus in a sample of pregnant women diagnosed with the disease. Diabetol Metab Syndr 2015;7:A80.10.1186/1758-5996-7-S1-A80Search in Google Scholar
6. Salman H, Shah M, Ali A, Aziz A, Vitale SG. Assessment of relationship of serum neurokinin-B level in the pathophysiology of pre-eclampsia: a case-control study. Adv Ther 2018;35:1114–21.10.1007/s12325-018-0723-zSearch in Google Scholar PubMed
7. Chiofalo B, Laganà AS, Vaiarelli A, La Rosa VL, Rossetti D, Palmara V, et al. Do miRNAs play a role in fetal growth restriction? A fresh look to a busy corner. Biomed Res Int 2017;2017:6073167.10.1155/2017/6073167Search in Google Scholar PubMed PubMed Central
8. Mustaniemi S, Vääräsmäki M, Eriksson JG, Gissler M, Laivuori H, Ijäs H, et al. Polycystic ovary syndrome and risk factors for gestational diabetes. Endocr Connect 2018;7:859–69.10.1530/EC-18-0076Search in Google Scholar PubMed PubMed Central
9. Pan ML, Chen LR, Tsao HM, Chen KH. Relationship between polycystic ovarian syndrome and subsequent gestational diabetes mellitus: a nationwide population-based study. PLoS One 2015;10:e0140544.10.1371/journal.pone.0140544Search in Google Scholar PubMed PubMed Central
10. Reyes-Muñoz E, Sathyapalan T, Rossetti P, Shah M, Long M, Buscema M, et al. Polycystic ovary syndrome: implication for drug metabolism on assisted reproductive techniques – a literature review. Adv Ther 2018;35:1805–15.10.1007/s12325-018-0810-1Search in Google Scholar PubMed PubMed Central
11. Laganà AS, Rossetti P, Sapia F, Chiofalo B, Buscema M, Valenti G, et al. Evidence-based and patient-oriented inositol treatment in polycystic ovary syndrome: changing the perspective of the disease. Int J Endocrinol Metab 2017;15:e43695.10.5812/ijem.43695Search in Google Scholar PubMed PubMed Central
12. McCarthy EA, Strauss BJ, Walker SP, Permezel M. Determination of maternal body composition in pregnancy and its relevance to perinatal outcomes. Obstet Gynecol Surv 2004;59:731–42.10.1097/01.ogx.0000140039.10861.91Search in Google Scholar PubMed
13. Despres JP. Treatment of obesity: need to focus on high risk abdominally obese patients. Br Med J 2001;322:716–20.10.1136/bmj.322.7288.716Search in Google Scholar PubMed PubMed Central
14. Hamdy O, Porramatikul S, Al-Ozairi E. Metabolic obesity: the paradox between visceral and subcutaneous fat. Curr Diabetes Rev 2006;2:367–73.10.2174/1573399810602040367Search in Google Scholar PubMed
15. Björntorp P. “Portal” adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990;10:493–6.10.1161/01.ATV.10.4.493Search in Google Scholar
16. Black D, Vora J, Hayward M, Marks R. Measurement of subcutaneous fat thickness with high frequency pulsed ultrasound: comparisons with a caliper and a radiographic technique. Clin Phys Physiol Meas 1988;9:57–64.10.1088/0143-0815/9/1/005Search in Google Scholar PubMed
17. Yang SH, Kim C, An HS, An H, Lee JS. Prediction of gestational diabetes mellitus in pregnant Korean women based on abdominal subcutaneous fat thickness as measured by ultrasonography. Diabetes Metab J 2017;41:486–91.10.4093/dmj.2017.41.6.486Search in Google Scholar PubMed PubMed Central
18. Kansu-Celik H, Karakaya BK, Tasci Y, Hancerliogullari N, Yaman S, Ozel S, et al. Relationship maternal subcutaneous adipose tissue thickness and development of gestational diabetes mellitus. Interv Med Appl Sci 2018;10:13–8.10.1556/1646.10.2018.01Search in Google Scholar PubMed PubMed Central
19. Gur EB, Ince O, Turan GA, Karadeniz M, Tatar S, Celik E, et al. Ultrasonographic visceral fat thickness in the first trimester can predict metabolic syndrome and gestational diabetes mellitus. Endocrine 2014;47:478–84.10.1007/s12020-013-0154-1Search in Google Scholar PubMed
20. Kennedy NJ, Peek MJ, Quinton AE, Lanzarone V, Martin A, Benzie R, et al. Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study. Br J Obstect Gynecol 2016;123:225–32.10.1111/1471-0528.13758Search in Google Scholar PubMed
21. Sommer C, Jenum AK, Waage CW, Mørkrid K, Sletner L, Birkeland KI. Ethnic differences in BMI, subcutaneous fat, and serum leptin levels during and after pregnancy and risk of gestational diabetes. Eur J Endocrinol 2015;172:649–56.10.1530/EJE-15-0060Search in Google Scholar
22. Metzger BE, International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33:676–82.10.2337/dc10-0719Search in Google Scholar
23. Committee on Practice Bulletins – Obstetrics. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol 2013;122:406–16.10.1097/01.AOG.0000433006.09219.f1Search in Google Scholar
24. van Leeuwen M, Louwerse MD, Opmeer BC, Limpens J, Serlie MJ, Reitsma JB, et al. Glucose challenge test for detecting gestational diabetes mellitus: a systematic review. Br J Obstect Gynecol 2012;119:393–401.10.1111/j.1471-0528.2012.03425.xSearch in Google Scholar
25. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008;61:344–9.10.1097/EDE.0b013e3181577654Search in Google Scholar
26. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982;144:768–73.10.1016/0002-9378(82)90349-0Search in Google Scholar
27. Widen EM, Gallagher D. Body composition changes in pregnancy: measurement, predictors and outcomes. Eur J Clin Nutr 2014;68:643–52.10.1038/ejcn.2014.40Search in Google Scholar PubMed PubMed Central
28. Karakelides H, Irving BA, Short KR, O’Brien P, Nair KS. Age, obesity, and sex effects on insulin sensitivity and skeletal muscle mitochondrial function. Diabetes 2010;59:89–97.10.2337/db09-0591Search in Google Scholar PubMed PubMed Central
29. Short KR, Bigelow ML, Kahl J, Singh R, Coenen-Schimke J, Raghavakaimal S, et al. Decline in skeletal muscle mitochondrial function with aging in humans. Proc Natl Acad Sci U S A 2005;102:5618–23.10.1073/pnas.0501559102Search in Google Scholar PubMed PubMed Central
©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis
- Research Articles – Obstetrics
- Total gestational weight gain and the risk of preeclampsia by pre-pregnancy body mass index categories: a population-based cohort study from 2013 to 2017
- Comparison of automated vs. manual measurement to estimate fetal weight in isolated polyhydramnios
- Strain and dyssynchrony in fetuses with congenital heart disease compared to normal controls using speckle tracking echocardiography (STE)
- Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus
- Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study
- Nearly half of all severe fetal anomalies can be detected by first-trimester screening in experts’ hands
- Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study
- Comparison of quantitative fluorescent polymerase chain reaction and karyotype analysis for prenatal screening of chromosomal aneuploidies in 270 amniotic fluid samples
- Effect of Sjögren’s syndrome on maternal and neonatal outcomes of pregnancy
- Intrapartum prediction of birth weight with a simplified algorithmic approach derived from maternal characteristics
- Efficacy of copy-number variation sequencing technology in prenatal diagnosis
- Socio-cultural and clinician determinants in the maternal decision-making process in the choice for trial of labor vs. elective repeated cesarean section: a questionnaire comparison between Italian settings
- Research Articles – Newborn
- Tidal volume monitoring during initial resuscitation of extremely prematurely born infants
- The level of extracellular superoxide dismutase in the first week of life in very and extremely low birth weight infants and the risk of developing bronchopulmonary dysplasia
- Effect of gender on growth-restricted fetuses born preterm
- Letters to the Editor
- Dermal bilirubin kinetics during phototherapy in term neonates
- Transcutaneous bilirubin to guide phototherapy: authors’ reply
Articles in the same Issue
- Frontmatter
- Review
- Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis
- Research Articles – Obstetrics
- Total gestational weight gain and the risk of preeclampsia by pre-pregnancy body mass index categories: a population-based cohort study from 2013 to 2017
- Comparison of automated vs. manual measurement to estimate fetal weight in isolated polyhydramnios
- Strain and dyssynchrony in fetuses with congenital heart disease compared to normal controls using speckle tracking echocardiography (STE)
- Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus
- Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study
- Nearly half of all severe fetal anomalies can be detected by first-trimester screening in experts’ hands
- Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study
- Comparison of quantitative fluorescent polymerase chain reaction and karyotype analysis for prenatal screening of chromosomal aneuploidies in 270 amniotic fluid samples
- Effect of Sjögren’s syndrome on maternal and neonatal outcomes of pregnancy
- Intrapartum prediction of birth weight with a simplified algorithmic approach derived from maternal characteristics
- Efficacy of copy-number variation sequencing technology in prenatal diagnosis
- Socio-cultural and clinician determinants in the maternal decision-making process in the choice for trial of labor vs. elective repeated cesarean section: a questionnaire comparison between Italian settings
- Research Articles – Newborn
- Tidal volume monitoring during initial resuscitation of extremely prematurely born infants
- The level of extracellular superoxide dismutase in the first week of life in very and extremely low birth weight infants and the risk of developing bronchopulmonary dysplasia
- Effect of gender on growth-restricted fetuses born preterm
- Letters to the Editor
- Dermal bilirubin kinetics during phototherapy in term neonates
- Transcutaneous bilirubin to guide phototherapy: authors’ reply
