Prediction of women's long-term cardiometabolic risks using glycemic indices during pregnancy
Article first published online: 13 AUG 2012
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 39, Issue 2, pages 484–491, February 2013
How to Cite
Tam, W. H., Ma, R. C. W., Yang, X., Ko, G. T. C., Lao, T. T. H., Sahota, D. S., Chan, M. H. M., Lam, C. W. K., Cockram, C. S. and Chan, J. C. N. (2013), Prediction of women's long-term cardiometabolic risks using glycemic indices during pregnancy. Journal of Obstetrics and Gynaecology Research, 39: 484–491. doi: 10.1111/j.1447-0756.2012.01976.x
- Issue published online: 28 JAN 2013
- Article first published online: 13 AUG 2012
- Received: November 27 2011.; Accepted: June 1 2012.
- diabetes mellitus;
- gestational diabetes mellitus;
- metabolic syndrome
Aims: To study the prediction of abnormal glucose tolerance (AGT), diabetes mellitus (DM), hypertension (HT) and metabolic syndrome (MetS) among Chinese women using glycemic indices in the mid-trimester of pregnancy.
Methods: A cohort of Chinese women who had had either normal glucose tolerance or gestational diabetes mellitus (GDM) during a pregnancy were assessed at a median of 8 and 15 years post-delivery. All women underwent a 50-g glucose challenge test (GCT) and a 75-g oral glucose tolerance test in the mid-trimester of the index pregnancy. A receiver operating characteristic curve was used to assess the prediction of AGT, DM, HT and MetS.
Results: All glycemic indices were significant predictors of AGT and DM, and the 2-h plasma glucose (PG) and GCT were predictive of HT, at both 8 and 15 years post-delivery. MetS can only be predicted by the fasting plasma glucose (FPG) and was confined to 15 years post-delivery. After adjustment for confounding variables, all glycemic indices were still independent predictors of AGT and DM at both 8 and 15 years post-delivery, except for FPG in predicting DM at 8 years, while only the 2-h PG remains an independent predictor of HT at 15 years. The optimal cut-off values for FPG, 2-h PG and GCT are 4.2 mmol/L, 7.2 mmol/L and 7.7 mmol/L, respectively; all are lower than the current cut-off thresholds for the screening and diagnosis of GDM.
Conclusions: Women who had a glycemic level below the criteria for a positive screening test and below the diagnostic threshold for GDM still have a significant cardiometabolic risk.