Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance

Sanmaan K. Basraon*, Lisa Mele, Leslie Myatt, James M. Roberts, John C. Hauth, Kenneth J. Leveno, Michael W. Varner, Ronald J. Wapner, John M. Thorp, Alan M Peaceman, Susan M. Ramin, Anthony Sciscione, Jorge E. Tolosa, Yoram Sorokin

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. Methods Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk women to prevent pregnancy associated hypertension. Women between 9 and 16 weeks with data for WHR and BMI were analyzed for GDM (n = 2,300). Those with fasting glucose and insulin between 22 and 26 weeks (n = 717) were analyzed for IR by homeostatic model assessment of IR (normal, ≤ 75th percentile). WHR and BMI were categorized as normal (WHR, < 0.80; BMI, < 25 kg/m2); overweight (WHR, 0.8-0.84; BMI, 25-29.9 kg/m2); and obese (WHR, ≥ 0.85; BMI ≥ 30 kg/m2). Receiver operating characteristic curves and logistic regression models were used. Results Compared with normal, the risks of GDM or IR were higher in obese by BMI or WHR. The subgroup with obesity by WHR but not by BMI had no increased risk of GDM. BMI was a better predictor of IR (area under the curve [AUC]: 0.71 [BMI], 0.65 [WHR], p = 0.03) but similar to WHR for GDM (AUC: 0.68 [BMI], 0.63 [WHR], p = 0.18). Conclusion Increased WHR and BMI in early pregnancy are associated with IR and GDM. BMI is a better predictor of IR compared with WHR. Adding WHR to BMI does not improve its ability to detect GDM or IR.

Original languageEnglish (US)
Pages (from-to)114-122
Number of pages9
JournalAmerican journal of perinatology
Volume33
Issue number1
DOIs
StatePublished - Sep 9 2015

Fingerprint

Waist-Hip Ratio
Gestational Diabetes
Insulin Resistance
Body Mass Index
Pregnancy
Area Under Curve
Obesity
Logistic Models
Aptitude
ROC Curve
Multicenter Studies
Fasting

Keywords

  • gestational diabetes mellitus
  • insulin resistance
  • maternal BMI
  • waist-to-hip ratio

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Basraon, Sanmaan K. ; Mele, Lisa ; Myatt, Leslie ; Roberts, James M. ; Hauth, John C. ; Leveno, Kenneth J. ; Varner, Michael W. ; Wapner, Ronald J. ; Thorp, John M. ; Peaceman, Alan M ; Ramin, Susan M. ; Sciscione, Anthony ; Tolosa, Jorge E. ; Sorokin, Yoram. / Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance. In: American journal of perinatology. 2015 ; Vol. 33, No. 1. pp. 114-122.
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title = "Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance",
abstract = "Objective To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. Methods Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk women to prevent pregnancy associated hypertension. Women between 9 and 16 weeks with data for WHR and BMI were analyzed for GDM (n = 2,300). Those with fasting glucose and insulin between 22 and 26 weeks (n = 717) were analyzed for IR by homeostatic model assessment of IR (normal, ≤ 75th percentile). WHR and BMI were categorized as normal (WHR, < 0.80; BMI, < 25 kg/m2); overweight (WHR, 0.8-0.84; BMI, 25-29.9 kg/m2); and obese (WHR, ≥ 0.85; BMI ≥ 30 kg/m2). Receiver operating characteristic curves and logistic regression models were used. Results Compared with normal, the risks of GDM or IR were higher in obese by BMI or WHR. The subgroup with obesity by WHR but not by BMI had no increased risk of GDM. BMI was a better predictor of IR (area under the curve [AUC]: 0.71 [BMI], 0.65 [WHR], p = 0.03) but similar to WHR for GDM (AUC: 0.68 [BMI], 0.63 [WHR], p = 0.18). Conclusion Increased WHR and BMI in early pregnancy are associated with IR and GDM. BMI is a better predictor of IR compared with WHR. Adding WHR to BMI does not improve its ability to detect GDM or IR.",
keywords = "gestational diabetes mellitus, insulin resistance, maternal BMI, waist-to-hip ratio",
author = "Basraon, {Sanmaan K.} and Lisa Mele and Leslie Myatt and Roberts, {James M.} and Hauth, {John C.} and Leveno, {Kenneth J.} and Varner, {Michael W.} and Wapner, {Ronald J.} and Thorp, {John M.} and Peaceman, {Alan M} and Ramin, {Susan M.} and Anthony Sciscione and Tolosa, {Jorge E.} and Yoram Sorokin",
year = "2015",
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Basraon, SK, Mele, L, Myatt, L, Roberts, JM, Hauth, JC, Leveno, KJ, Varner, MW, Wapner, RJ, Thorp, JM, Peaceman, AM, Ramin, SM, Sciscione, A, Tolosa, JE & Sorokin, Y 2015, 'Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance', American journal of perinatology, vol. 33, no. 1, pp. 114-122. https://doi.org/10.1055/s-0035-1562928

Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance. / Basraon, Sanmaan K.; Mele, Lisa; Myatt, Leslie; Roberts, James M.; Hauth, John C.; Leveno, Kenneth J.; Varner, Michael W.; Wapner, Ronald J.; Thorp, John M.; Peaceman, Alan M; Ramin, Susan M.; Sciscione, Anthony; Tolosa, Jorge E.; Sorokin, Yoram.

In: American journal of perinatology, Vol. 33, No. 1, 09.09.2015, p. 114-122.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance

AU - Basraon, Sanmaan K.

AU - Mele, Lisa

AU - Myatt, Leslie

AU - Roberts, James M.

AU - Hauth, John C.

AU - Leveno, Kenneth J.

AU - Varner, Michael W.

AU - Wapner, Ronald J.

AU - Thorp, John M.

AU - Peaceman, Alan M

AU - Ramin, Susan M.

AU - Sciscione, Anthony

AU - Tolosa, Jorge E.

AU - Sorokin, Yoram

PY - 2015/9/9

Y1 - 2015/9/9

N2 - Objective To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. Methods Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk women to prevent pregnancy associated hypertension. Women between 9 and 16 weeks with data for WHR and BMI were analyzed for GDM (n = 2,300). Those with fasting glucose and insulin between 22 and 26 weeks (n = 717) were analyzed for IR by homeostatic model assessment of IR (normal, ≤ 75th percentile). WHR and BMI were categorized as normal (WHR, < 0.80; BMI, < 25 kg/m2); overweight (WHR, 0.8-0.84; BMI, 25-29.9 kg/m2); and obese (WHR, ≥ 0.85; BMI ≥ 30 kg/m2). Receiver operating characteristic curves and logistic regression models were used. Results Compared with normal, the risks of GDM or IR were higher in obese by BMI or WHR. The subgroup with obesity by WHR but not by BMI had no increased risk of GDM. BMI was a better predictor of IR (area under the curve [AUC]: 0.71 [BMI], 0.65 [WHR], p = 0.03) but similar to WHR for GDM (AUC: 0.68 [BMI], 0.63 [WHR], p = 0.18). Conclusion Increased WHR and BMI in early pregnancy are associated with IR and GDM. BMI is a better predictor of IR compared with WHR. Adding WHR to BMI does not improve its ability to detect GDM or IR.

AB - Objective To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. Methods Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk women to prevent pregnancy associated hypertension. Women between 9 and 16 weeks with data for WHR and BMI were analyzed for GDM (n = 2,300). Those with fasting glucose and insulin between 22 and 26 weeks (n = 717) were analyzed for IR by homeostatic model assessment of IR (normal, ≤ 75th percentile). WHR and BMI were categorized as normal (WHR, < 0.80; BMI, < 25 kg/m2); overweight (WHR, 0.8-0.84; BMI, 25-29.9 kg/m2); and obese (WHR, ≥ 0.85; BMI ≥ 30 kg/m2). Receiver operating characteristic curves and logistic regression models were used. Results Compared with normal, the risks of GDM or IR were higher in obese by BMI or WHR. The subgroup with obesity by WHR but not by BMI had no increased risk of GDM. BMI was a better predictor of IR (area under the curve [AUC]: 0.71 [BMI], 0.65 [WHR], p = 0.03) but similar to WHR for GDM (AUC: 0.68 [BMI], 0.63 [WHR], p = 0.18). Conclusion Increased WHR and BMI in early pregnancy are associated with IR and GDM. BMI is a better predictor of IR compared with WHR. Adding WHR to BMI does not improve its ability to detect GDM or IR.

KW - gestational diabetes mellitus

KW - insulin resistance

KW - maternal BMI

KW - waist-to-hip ratio

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U2 - 10.1055/s-0035-1562928

DO - 10.1055/s-0035-1562928

M3 - Article

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JO - American Journal of Perinatology

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SN - 0735-1631

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