title: Predicting gestational diabetes mellitus during the first trimester using anthropometric measurements and HOMA-IR.
abstract: OBJECTIVE
  To determine the predictability of gestational diabetes mellitus (GDM) during the first trimester using the degree of insulin resistance and anthropometric measurements and to assign the risk of developing GDM by weight gained during pregnancy (WGDP).
  
  
  METHODS
  A total of 250 singleton pregnancies at 7-12 gestational weeks were studied. Body mass index (BMI), waist/hip ratio (WHR), quantitative insulin sensitivity check index (QUICKI), homeostasis model assessment-insulin resistance (HOMA-IR) scores and WGDP were determined. The backward stepwise method was applied to estimate possible associations with GDM. Cutoff points were estimated using receiver operating characteristic curve analysis.
  
  
  RESULTS
  GDM was found in 20 of 227 singleton pregnancies (8.8 %). The calculated HOMA-IR, QUICKI, BMI, WHR, WGDP, and parity were significantly associated with GDM. Logistic regression analyses showed that three covariates (HOMA-IR, BMI, WGDP) remained independently associated with GDM. It was calculated as OR 1.254 (95 % CI 1.006-1.563), AUC 0.809, sensitivity 90 %, specificity 61 % with cutoff = 2.08 for HOMA-IR; OR 1.157 (CI 1.045-1.281), AUC 0.723, sensitivity 80 %, specificity 58 % with cutoff = 25.95 for BMI; OR 1.221, (CI 1.085-1.374), AUC 0.654, sensitivity 80 %, specificity 46 % with cutoff = 4.7 for WGDP. Despite a HOMA-IR score of >3.1 in pregnant women, GDM was detected in only three of 29 patients (10.3 %) if WGDP was <4.7 kg at weeks 24-28.
  
  
  CONCLUSIONS
  First trimester screening for GDM can be achieved based on maternal anthropometric measurements and HOMA-IR. In particular, if BMI is >25.95 kg/m(2) and the HOMA-IR score >2.08, controlling weight gain may protect against GDM.
authors.affiliation: Department of Obstetrics and Gynecology, Mevlana University Faculty of Medicine, Konya, Turkey. alptekinhusnu74@hotmail.com.
authors.forename: Hüsnü
authors.initials: H
authors.lastname: Alptekin
authors.affiliation: Department of Internal Medicine, Mevlana University Faculty of Medicine, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Çizmecioğlu
authors.affiliation: Department of Obstetrics and Gynecology, Mevlana University Faculty of Medicine, Konya, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Işık
authors.affiliation: Department of Obstetrics and Gynecology, Mevlana University Faculty of Medicine, Konya, Turkey.
authors.forename: Türkan
authors.initials: T
authors.lastname: Cengiz
authors.affiliation: Department of Internal Medicine, Mevlana University Faculty of Medicine, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yildiz
authors.affiliation: Department of Medical Education and Informatics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Mehmet Sinan
authors.initials: MS
authors.lastname: Iyisoy
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012372:ROC Curve; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose
keywords: Body mass index; First trimester pregnancy; Gestational diabetes mellitus; Insulin resistance; Waist/hip ratio; Weight gain