@article{c2834e5d9f8b40adad4e0f1e12b195ed,
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",
note = "Funding Information: The project described was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (HD34208, HD27869, HD40485, HD40560, HD40544, HD34116, HD40512, HD21410, HD40545, HD40500, HD27915, HD34136, HD27860, HD53118, HD53097, HD27917, and HD36801); the National Heart, Lung, and Blood Institute; and the National Center for Research Resources (M01 RR00080, UL1 RR024153, UL1 RR024989), and its contents do not necessarily represent the official view of NICHD, NHLBI, NCRR, or NIH. The authors thank the following network members who participated in protocol development and coordination between clinical research centers (Sabine Bousleiman and Margaret Cotroneo), protocol/data management and statistical analysis (Elizabeth Thom and Rebecca G. Clifton), and protocol development and oversight (George Saade, Gail D. Pearson, and Catherine Y. Spong). In addition to the authors, other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network are as follows: University of Texas Medical Branch, Galveston, TX: G. Saade, J. Moss, B. Stratton, G. Hankins, J. Brandon, C. Nelson-Becker, G. Olson, L. Pacheco. University of Pittsburgh, Pittsburgh, PA: S. Caritis, T. Kamon (deceased), M. Cotroneo, D. Fischer. University of Utah, Salt Lake City, UT: P. Reed, S. Quinn (LDS Hospital), V. Morby (McKay-Dee Hospital), F. Porter (LDS Hospital), R. Silver, J. Miller (Utah Valley Regional Medical Center), K. Hill. University of Alabama at Birmingham, Birmingham, AL: D. J. Rouse, A. Northen, P. Files, J. Grant, M. Wallace, K. Bailey. Columbia University, New York, NY: S. Bousleiman, R. Alcon, K. Saravia, F. Loffredo, A. Bayless (Christiana), C. Perez (St. Peter''s University Hospital), M. Lake (St. Peter''s University Hospital), M. Talucci. University of North Carolina at Chapel Hill, Chapel Hill, NC: K. Boggess, K. Dorman, J. Mitchell, K. Clark, S. Timlin. CaseWestern Reserve University-MetroHealth Medical Center, Cleveland, OH: B. Mercer, J. Bailit, C. Milluzzi, W. Dalton, C. Brezine, D. Bazzo. University of Texas Southwestern Medical Center, Dallas, TX: K. J. Sheffield, L.Moseley,M. Santillan, K. Buentipo, J. Price, L. S. Hermann, C. Melton, Y. Gloria-McCutchen, B. Espino. Northwestern University, Chicago, IL: M. Dinsmoor (NorthShore University HealthSystem), T. Matson-Manning, G. Mallett. University of Texas Health Science Center at Houston-Children{\textquoteright}s Memorial Hermann Hospital, Houston, TX: S. Blackwell, K. Cannon, S. Lege-Humbert, Z. Spears. Brown University, Providence, RI: M. Carpenter, J. Tillinghast, M. Seebeck. The Ohio State University, Columbus, OH: P. Samuels, J. Iams, F. Johnson, S. Fyffe, C. Latimer, S. Frantz, S. Wylie. Drexel University, Philadelphia, PA: M. Talucci, M. Hoffman (Christiana), J. Benson (Christiana), Z. Reid, C. Tocci. Wake Forest University Health Sciences, Winston-Salem, NC: M. Harper, P. Meis, M. Swain. Oregon Health & Science University, Portland, OR: W. Smith, L. Davis, E. Lairson, S. Butcher, S.Maxwell, D. Fisher. Wayne State University, Detroit, MI: G. Norman, S. Blackwell, P. Lockhart, D. Driscoll, M. Dombrowski. The GeorgeWashington University Biostatistics Center, Washington, DC: E. Thom, R. Clifton, T. Boekhoudt, L. Leuchtenburg. National Heart, Lung, and Blood Institute, Bethesda, MD: G. Pearson, V. Pemberton, J. Cutler, W. Barouch. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD: C. Spong, S. Tolivaisa. MFMU Steering Committee Chair (University of Texas Medical Center, Galveston, TX): G. D. Anderson. Publisher Copyright: Copyright {\textcopyright} 2016 by Thieme Medical Publishers, Inc.",
year = "2015",
month = sep,
day = "9",
doi = "10.1055/s-0035-1562928",
language = "English (US)",
volume = "33",
pages = "114--122",
journal = "American Journal of Perinatology",
issn = "0735-1631",
publisher = "Thieme Medical Publishers",
number = "1",
}