The Association of the Triglyceride and Muscle to Fat Ratio During Early Pregnancy with the Development of Gestational Diabetes Mellitus.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 37867631 · doi:10.2147/DMSO.S431264
What was done
A prospective cohort study recruited pregnant women during their first trimester. Clinical characteristics, blood glucose, and lipid profiles were collected, and body composition was assessed using multifrequency bioelectrical impedance analysis. Gestational diabetes mellitus (GDM) was diagnosed using an oral glucose tolerance test at 24–28 weeks of gestation. Poisson regression was used to evaluate risk ratios (RRs) and 95% confidence intervals, and receiver operating characteristic (ROC) curves evaluated predictive performance.
What was found
Of 302 women, 59 (19.5%) developed GDM. Significant predictors in early pregnancy were higher triglycerides (RR 4.052, 95% CI 1.641–6.741), higher skeletal muscle mass to fat mass ratio (SMM/FM) as a protective factor (RR 0.213, 95% CI 0.051–0.890), older age (RR 1.076, 95% CI 1.005–1.152), higher pre-pregnancy BMI (RR 1.012, 95% CI 1.005–1.063), and family history of type 2 diabetes (RR 1.496, 95% CI 1.014–2.667). First-trimester fasting plasma glucose and glycated albumin showed no significant association with GDM. The combined multivariate model had an AUC of 0.806 (95% CI 0.737–0.895, P < 0.001), with ROC cut-off values of 0.925 mmol/L for triglycerides and 1.305 for SMM/FM.
Why it matters
Measuring first-trimester lipid profiles and body composition metrics such as the muscle-to-fat ratio may help identify women at elevated risk for GDM earlier than conventional mid-pregnancy screening.
Limits
The study was a single-cohort observational analysis with a modest sample size (n = 302, 59 GDM cases) and no external validation. Bioelectrical impedance analysis was used to assess body composition, which can be influenced by pregnancy-related hydration changes.
Cited by
- supports Having higher muscle mass during pregnancy is protective against developing gestational diabetes.