HOMA‐IR as a risk factor of gestational diabetes mellitus and a novel simple surrogate index in early pregnancy. Issue 3 (24th September 2021) - Song, Shuoning
Abstract: Objective: To assess the association between insulin resistance and gestational diabetes mellitus (GDM) in early pregnancy and find a simple surrogate index of the homeostasis model assessment of insulin resistance (HOMA‐IR). Methods: A total of 700 pregnant women were included in this prospective, double‐center, observational cohort study. The glucose and lipid metabolic characterization was performed at 6–12 weeks of pregnancy. All participants underwent a 75‐g oral glucose tolerance test at 24–28 weeks of pregnancy. Linear regression analysis was applied to find a novel surrogate index of HOMA‐IR. Binary logistic analysis was applied to estimate possible associations of different indices with GDM and insulin resistance. Results: GDM was diagnosed in 145 of 700 women with singleton pregnancies (20.7%). HOMA‐IR was higher in the GDM group than in the normal glucose tolerance (NGT) group and was an individual risk factor for GDM (adjusted risk ratio RR 1.371, 95% confidence interval [CI] 1.129–1.665, P < 0.001). TyHGB index as the surrogate index of HOMA‐IR was represented as TG/HDL‐C + 0.7*FBG (mmol/L) +0.1*preBMI (kg/m 2 )(where TG/HDL‐C is triglyceride/high‐density lipoprotein cholesterol; FBG is fasting blood glucose, and preBMI is the pre‐pregnancy body mass index [calculated as weight in kilograms divided by the square of height in meters]). The cut‐off point of the TyHGB index was 6.0 (area under the curve 0.827, 95% CI 0.794–0.861, P < 0.001) for mild insulin resistance. Conclusion: Increased HOMA‐IR in early pregnancy was a risk factor of GDM. TyHGB index could be a surrogate index of HOMA‐IR and had a predictive value for GDM.