Abdominal Subcutaneous Fat Thickness and Glucose Challenge Test may predict Gestational Diabetes claims study

Gestational diabetes mellitus (GDM) refers to the occurrence of diabetes or impaired carbohydrate intolerance during the second or third trimester of pregnancy, and it does not include pre-existing type 1 or type 2 diabetes. Recent study investigated the combined use of abdominal subcutaneous fat thickness (ASFT) and a 50-g glucose challenge test (GCT) in the second trimester to predict the development of gestational diabetes mellitus (GDM). The study involved 728 pregnant women, and the results suggest that this combined approach had high sensitivity and specificity in predicting GDM cases.

Maternal obesity is strongly linked with adverse perinatal and maternal outcomes, including insulin resistance, GDM, and metabolic syndrome. However, the prevalence of GDM shows significant differences among pregnant women with obesity. Ultrasonography is a useful tool to assess the amount of maternal central fat throughout gestation. Previous studies by the authors found that an increased ASFT (>18.1 mm) was highly associated with the subsequent development of GDM.

In this study, all pregnant women underwent ASFT measurement and a 50-g GCT between 24-28 weeks of gestation. Even if the 50-g GCT was normal, 100-g oral glucose tolerance test (OGTT) was offered to patients with an ASFT value above 18.1 mm. Among the 728 women, 154 (21.2%) were screened positive on the 50-g GCT, and 43 (5.9%) were eventually diagnosed with GDM after the 100-g OGTT. In total, 67 (9.2%) had an ASFT measurement above 18.1 mm.

The key findings are that a 50-g GCT combined with ASFT measurement above 18.1 mm predicted GDM with a sensitivity of 87.9%, a specificity of 88.7%, a positive predictive value (PPV) of 36.0%, and a negative predictive value (NPV) of 99.7%. This suggests that this combined approach during routine antenatal care in the second trimester could be a beneficial indicator for predicting GDM cases.

The authors conclude that ASFT measurement is anticipated to be extensively used as an indicative variable for predicting GDM cases during the second trimester of pregnancy. This simple, non-invasive measurement could help identify pregnant women at higher risk of GDM who may benefit from early testing and intervention, potentially improving maternal and fetal outcomes.

Key Points -

Here are the 6 key points from the research paper:

1. The study investigated the combined use of abdominal subcutaneous fat thickness (ASFT) and a 50-g glucose challenge test (GCT) in the second trimester to predict the development of gestational diabetes mellitus (GDM) in 728 pregnant women.

2. Previous studies by the authors found that an increased ASFT (>18.1 mm) was highly associated with the subsequent development of GDM.

3. In this study, all pregnant women underwent ASFT measurement and a 50-g GCT between 24-28 weeks of gestation. Women with an ASFT value above 18.1 mm underwent a 100-g oral glucose tolerance test (OGTT) even if the 50-g GCT was normal.

4. The key finding was that the combination of a 50-g GCT and ASFT measurement above 18.1 mm predicted GDM with a sensitivity of 87.9%, a specificity of 88.7%, a positive predictive value (PPV) of 36.0%, and a negative predictive value (NPV) of 99.7%.

5. The authors conclude that ASFT measurement is anticipated to be extensively used as an indicative variable for predicting GDM cases during the second trimester of pregnancy.

6. This simple, non-invasive measurement could help identify pregnant women at higher risk of GDM who may benefit from early testing and intervention, potentially improving maternal and fetal outcomes.

Reference –

Süleyman Cemil Oğlak, Emine Zeynep Yılmaz & Mehmet Şükrü Budak (2024) Abdominal subcutaneous fat thickness combined with a 50-g glucose challenge test at 24-28 weeks of pregnancy in predicting gestational diabetes mellitus, Journal of Obstetrics and Gynaecology, 44:1, 2329880, DOI: 10.1080/01443615.2024.2329880