Predictability of HOMA-IR for Gestational Diabetes Mellitus in Early Pregnancy Based on Different First Trimester BMI Values

• Published in: Journal of personalized medicine Vol. 13; no. 1; p. 60
• Main Authors: Duo, Yanbei, Song, Shuoning, Zhang, Yuemei, Qiao, Xiaolin, Xu, Jiyu, Zhang, Jing, Peng, Zhenyao, Chen, Yan, Nie, Xiaorui, Sun, Qiujin, Yang, Xianchun, Wang, Ailing, Sun, Wei, Fu, Yong, Dong, Yingyue, Lu, Zechun, Yuan, Tao, Zhao, Weigang
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.12.2022; MDPI
• Subjects: Birth weight; Blood pressure; Body mass index; Body weight; Childrens health; Cholesterol; Correlation analysis; Diabetes mellitus; Disease; Family medical history; Gestation; Gestational diabetes; Glucose; Glucose tolerance; Homeostasis; Insulin; Insulin resistance; Laboratories; Maternal & child health; Obesity; Overweight; Precision medicine; Pregnancy; Pregnancy complications; Risk factors; Statistical significance; Weight control; Womens health; China; HOMA-IR; predictability; body mass index; early pregnancy; gestational diabetes
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm13010060

Objective: To investigate the ability of homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy for predicting gestational diabetes mellitus (GDM) in Chinese women with different first-trimester body mass index (FT-BMI) values. Methods: Baseline characteristics and laboratory tests were collected at the first prenatal visit (6–12 weeks of gestation). GDM was diagnosed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression were applied to identify the association between HOMA-IR and GDM. The cutoff points for predicting GDM were estimated using receiver operating characteristic (ROC) curve analysis. Results: Of the total of 1343 women, 300 (22.34%) were diagnosed with GDM in the 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression verified HOMA-IR as a significant risk factor for GDM in the normal weight subgroup (FT-BMI < 24 kg/m2) (adjusted OR 2.941 [95% CI 2.153, 4.016], P < 0.001), overweight subgroup (24.0 kg/m2 ≤ FT-BMI < 28.0 kg/m2) (adjusted OR 3.188 [95% CI 2.011, 5.055], P < 0.001), and obese subgroup (FT-BMI ≥ 28.0 kg/m2) (adjusted OR 9.415 [95% CI 1.712, 51.770], p = 0.01). The cutoff values of HOMA-IR were 1.52 (area under the curve (AUC) 0.733, 95% CI 0.701–0.765, p < 0.001) for all participants, 1.43 (AUC 0.691, 95% CI 0.651–0.730, p < 0.001) for normal weight women, 2.27 (AUC 0.760, 95% CI 0.703–0.818, p < 0.001) for overweight women, and 2.31 (AUC 0.801, 95% CI 0.696–0.907, p < 0.001) for obese women. Conclusions: Increased HOMA-IR in early pregnancy is a risk factor for GDM, and HOMA-IR can be affected by body weight. The cutoff value of HOMA-IR to predict GDM should be distinguished by different FT-BMI values.