Abstract：
UNASSIGNED: Anthropometric measurement provides a simple, noninvasive approach to evaluate obesity in pregnant women. We aimed to develop a predictive model utilizing anthropometric index for gestational diabetes mellitus (GDM), the most common obesity-related complications during pregnancy.
UNASSIGNED: A prospective cohort of 4709 women was enrolled in Qingdao, China. Logistic regression model was constructed to determine the association of body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) in the first trimester (<14 weeks\' gestation) with GDM. The discrimination ability for GDM was assessed using areas under the receiver operating characteristic (ROC) curve (AUC). Delong tests were performed to compare AUC values between different measures.
UNASSIGNED: The GDM incidence was 19.50%. GDM risk increased with VAT during early pregnancy, and the risk increased by 117% (OR = 2.17, 95% CI: 1.23-2.83) to 326% (OR = 4.26, 95% CI: 2.29-7.91) in pregnant women with the second quartile or above after adjusting for confounders (all p<.05). Combined index using VAT and BMI demonstrated superior predictive power for GDM compared with BMI alone (p<.05), but didn\'t differ from VAT (p>.05). Overall, VAT was positively correlated with GDM occurrence, outperforming BMI, WHR, WHtR and SAT in the predicative model. A first-trimester VAT cutoff of 27.05 mm might be promising for GDM risk stratification.
UNASSIGNED: First-trimester routine ultrasound screening may facilitate earlier identification and intervention of GDM. Pregnant women with VAT above the optimal threshold (27.05 mm) might benefit from targeted GDM monitoring.
UNASSIGNED: A prospective cohort of 4709 women was enrolled in Qingdao, China. Logistic regression model was constructed to determine the association of body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) in the first trimester (<14 weeks\' gestation) with GDM. The discrimination ability for GDM was assessed using areas under the receiver operating characteristic (ROC) curve (AUC). Delong tests were performed to compare AUC values between different measures.
UNASSIGNED: The GDM incidence was 19.50%. GDM risk increased with VAT during early pregnancy, and the risk increased by 117% (OR = 2.17, 95% CI: 1.23-2.83) to 326% (OR = 4.26, 95% CI: 2.29-7.91) in pregnant women with the second quartile or above after adjusting for confounders (all p<.05). Combined index using VAT and BMI demonstrated superior predictive power for GDM compared with BMI alone (p<.05), but didn\'t differ from VAT (p>.05). Overall, VAT was positively correlated with GDM occurrence, outperforming BMI, WHR, WHtR and SAT in the predicative model. A first-trimester VAT cutoff of 27.05 mm might be promising for GDM risk stratification.
UNASSIGNED: First-trimester routine ultrasound screening may facilitate earlier identification and intervention of GDM. Pregnant women with VAT above the optimal threshold (27.05 mm) might benefit from targeted GDM monitoring.
摘要：
■人体测量提供了一种简单的，评估孕妇肥胖的非侵入性方法。我们旨在开发一种利用人体测量指数对妊娠期糖尿病（GDM）的预测模型，怀孕期间最常见的肥胖相关并发症。
■在青岛招募了4709名女性的前瞻性队列，中国。建立Logistic回归模型,确定体重指数(BMI)、腰臀比（WHR），腰围与身高比(WHtR)，皮下脂肪组织（SAT），GDM患者妊娠早期(<14周)的内脏脂肪组织(VAT)。使用受试者工作特征(ROC)曲线(AUC)下面积评估GDM的辨别能力。进行Delong测试以比较不同测量之间的AUC值。
■GDM发生率为19.50%。妊娠早期GDM风险随增值税增加，在校正混杂因素后，第二个四分位数或以上的孕妇的风险增加了117％（OR=2.17，95％CI：1.23-2.83）至326％（OR=4.26，95％CI：2.29-7.91）（所有p<0.05）。与单独的BMI相比，使用VAT和BMI的综合指数对GDM具有更好的预测能力（p<0.05），但与增值税没有区别（p>0.05）。总的来说,增值税与GDM发生呈正相关,表现优于BMI，WHR,预测模型中的WHtR和SAT。27.05mm的孕早期增值税临界值可能对GDM风险分层很有希望。
■孕早期常规超声筛查可以促进GDM的早期识别和干预。VAT高于最佳阈值（27.05mm）的孕妇可能会受益于针对性的GDM监测。
■在青岛招募了4709名女性的前瞻性队列，中国。建立Logistic回归模型,确定体重指数(BMI)、腰臀比（WHR），腰围与身高比(WHtR)，皮下脂肪组织（SAT），GDM患者妊娠早期(<14周)的内脏脂肪组织(VAT)。使用受试者工作特征(ROC)曲线(AUC)下面积评估GDM的辨别能力。进行Delong测试以比较不同测量之间的AUC值。
■GDM发生率为19.50%。妊娠早期GDM风险随增值税增加，在校正混杂因素后，第二个四分位数或以上的孕妇的风险增加了117％（OR=2.17，95％CI：1.23-2.83）至326％（OR=4.26，95％CI：2.29-7.91）（所有p<0.05）。与单独的BMI相比，使用VAT和BMI的综合指数对GDM具有更好的预测能力（p<0.05），但与增值税没有区别（p>0.05）。总的来说,增值税与GDM发生呈正相关,表现优于BMI，WHR,预测模型中的WHtR和SAT。27.05mm的孕早期增值税临界值可能对GDM风险分层很有希望。
■孕早期常规超声筛查可以促进GDM的早期识别和干预。VAT高于最佳阈值（27.05mm）的孕妇可能会受益于针对性的GDM监测。
