Homeostatic model assessment of beta cell function predicting abnormal oral glucose tolerance testing in pregnancy: a systematic review and meta-analysis. (2nd December 2017)

• Record Type: Journal Article
• Authors: Ellerbrock, Jonas; Bohnen, Jolijn M. H. A.; Lopes van Balen, Veronica A.; Mulder, Eva G.; Aardenburg, Robert; Spaanderman, Marc E. A.
• Is Part Of: Gynecological endocrinology. Volume 33:Number 12(2017)
• Page Start: 911
• Page End: 917
• Publication Date: 2017-12-02
• Subjects: Gestational diabetes -- beta cell function -- insulin secreting cells -- homeostatic model assessment -- HOMA -- prediction -- insulin resistance; Endocrine gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 618.1
• DOI: 10.1080/09513590.2017.1369516
• Languages: English
• ISSNs: 0951-3590

Abstract

Abstract: Background: Gestational diabetes mellitus (GDM) complicates 1–14% of pregnancies and relates to increased risk of adverse obstetric outcomes. Currently GDM is diagnosed using an oral glucose tolerance test (OGTT), which is burdensome and time intensive. Objective: To compare current literature on whether the homeostatic model assessment beta cell function (HOMA-β) is an accurate predictor of an abnormal OGTT in pregnant women. Methods: Pubmed, Cochrane and Embase were searched. Included studies evaluated pregnant women at risk for GDM using the homeostatic model assessment of beta cell function (HOMA-β) for the assessment of beta cell function and the OGTT. Studies with animals, non-pregnant women, women with type 2 diabetes and post-partum diabetes were excluded. The QUADAS-2 criteria were used to assess the methodological quality of studies. Results: A total of 12 studies were included, reporting on 7292 women. Seven studies showed a difference in beta cell function between women with impaired glucose tolerance compared to healthy pregnant women. HOMA-β is significantly lower in impaired glucose tolerance ( p < 0.001). Conclusions: Although HOMA-β is lower in women with abnormal OGTT in pregnancy, given the high degree of heterogeneity of studies, we do not propagate HOMA-β as a sole diagnostic tool replacing OGTT to diagnose GDM.