medwireNews: The visceral fat tissue depth (VAD) measured in the first trimester of pregnancy predicts gestational diabetes better than current clinical indicators.
The technique had a positive predictive value (PPV) of 41.3% when tested on 123 pregnant women with clinical risk factors for gestational diabetes.
Robert D’Arcy (Royal Victoria Hospital, Belfast, UK) presented the results at the UK’s 2021 diabetes virtual conference, and said the PPV for VAD measurement is about twice that of the UK’s National Institute for Health and Care Excellence Recommended Clinical Predictor.
All women in the study had one or more risk factors, namely a BMI of 30 kg / m2 or greater, a family history of diabetes, a high-risk ethnicity, or a previous macrosomic child. People with previous gestational diabetes or elevated glycated hemoglobin levels were excluded.
Most women were recruited because of a high BMI; However, D’Arcy pointed out that BMI correlates poorly with visceral adipose tissue, which is known to adversely affect cardiometabolic risk, while subcutaneous fat is relatively benign.
The direct measurement of body fat by means of ultrasound showed no connection between subcutaneous fat and gestational diabetes risk, but the VAD with a cutoff of 3.98 cm was 73.1% sensitive and 72.2% specific for a later gestational diabetes diagnosis, which was assessed by an early oral glucose tolerance test in the third trimester.
The mean VAD was 4.22 cm in women who later developed gestational diabetes and 3.12 cm in women who did not.
D’Arcy emphasized the simplicity of the technique. “I assume midwives would do this at the time of the first routine scan if this were put into clinical practice,” he said, adding that those midwives who learned the technique during the study considered so would have felt uncomplicated.
However, he cautioned that a larger study is needed before the VAD measurement can be used to predict gestational diabetes in clinical practice.
medwireNews is an independent medical news service from Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
Diabetes UK Professional Conference 2021; April 19-30
