title: Abdominal adiposity and insulin resistance in early pregnancy.
abstract: BACKGROUND
  High pre-pregnancy body mass index is a known risk factor for gestational diabetes mellitus, but the contribution of abdominal adiposity to insulin resistance (IR) in pregnancy is not well understood. We assessed the association between abdominal adiposity in early pregnancy and IR.
  
  
  METHODS
  We completed a prospective cohort study of 79 pregnant women. Visceral adipose tissue (VAT) depth was measured by ultrasonography at 11 to 14 weeks' gestation, at the time of routine fetal nuchal translucency assessment. A two-hour 75 g oral glucose tolerance test was subsequently completed at 16 to 22 weeks' gestation and IR was estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) as well as by the insulin sensitivity index.
  
  
  RESULTS
  After adjusting for maternal age, parity, ethnicity, and pre-pregnancy BMI, VAT depth explained 42% of the variance in HOMA-IR, which was slightly better than the variance in the multivariable model examining HOMA-IR and pre-pregnancy BMI (40%). For the insulin sensitivity index, the model variance values were 36% and 32%, respectively.
  
  
  CONCLUSIONS
  Measurement of maternal adipose tissue depth at the time of routine first-trimester ultrasonography may provide additional information about maternal IR, beyond pre-pregnancy BMI.
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON; Institute of Medical Science, University of Toronto, Toronto ON.
authors.forename: Leanne R
authors.initials: LR
authors.lastname: De Souza
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON.
authors.forename: Eva
authors.initials: E
authors.lastname: Kogan
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON.
authors.forename: Howard
authors.initials: H
authors.lastname: Berger
authors.affiliation: Instituto de Medicina Integral Prof Fernando Figueira (IMIP), Recife, Brazil.
authors.forename: João G
authors.initials: JG
authors.lastname: Alves
authors.affiliation: Department of Health Policy Management Evaluation, University of Toronto, Toronto ON.
authors.forename: Gerald
authors.initials: G
authors.lastname: Lebovic
authors.affiliation: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto ON.
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON.
authors.forename: Jonathon L
authors.initials: JL
authors.lastname: Maguire
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON; Institute of Medical Science, University of Toronto, Toronto ON; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON; Department of Health Policy Management Evaluation, University of Toronto, Toronto ON; Department of Medicine, St. Michael's Hospital, Toronto ON.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Ray
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D014463:Ultrasonography
keywords: body mass index; central adiposity; gestational diabetes; glucose handling; insulin resistance; insulin sensitivity index; obesity