Insulin Resistance in Gestational Diabetes Mellitus and Its Association With Anthropometric Fetal Indices

Abstract

Background: In pregnant women with gestational diabetes mellitus (GDM), insulin resistance (IR) increases the risk of developing manifest type 2 diabetes mellitus and is associated with complications in both mother and fetus. Objectives: This research aimed to evaluate the associations between IR evaluated by 3 indices (namely updated homeostasis model assessment model (HOMA2), QUICKI, and McAuley’s index) and the diabetes risk factors and the fetal growth indices in Vietnamese women with GDM. Methods: A cross-sectional descriptive study was conducted on 370 women with GDM and 40 healthy pregnant women from January 2015 to May 2019. IR was calculated by HOMA2 (HOMA2-IR), QUICKI, and McAuley’s index. Fetal anthropometric measurements were assessed via ultrasound which was performed and interpreted by ultrasound experts. Results: In the simple regression analysis, McAuley’s index illustrated had statistically significant correlations to the highest number of risk factors of diabetes mellitus compared with HOMA2-IR and QUICKI indices. Moreover, McAuley’s index correlated statistically significantly to the highest number of fetal ultrasound measurements factors such as including biparietal diameter (BPD) ( r = −0.271, P < .001), head circumference (HC) ( r = −0.225, P < .001), abdominal circumference (AC) ( r = −0.214, P < .001), femur length (FL) ( r = −0.231, P < .001), estimated fetal weight (EFW) ( r = −0.239, P < .001) and fetal estimated age ( r = −0.299, P < .001). In the multivariable analysis, the McAuley’s index contributed the greatest to AC (Standardized B of −0.656, P < .001). Conclusion: The McAuley’s index was significantly associated with a higher number of more risk factors for diabetes mellitus as well as fetal ultrasound sonography findings measurements than compared with HOMA2-IR and QUICKI indices.

Relationship Between Maternal Serum Cortisol and Maternal Insulin Resistance and Fetal Ultrasound Characteristics in Gestational Diabetes Mellitus

“…Research by Le et al showed that, in GDM, the McAuley index is more meaningful in assessing insulin resistance and fetal abnormalities than other common insulin resistance indices built based on a healthy population and solely on serum glucose and insulin or C-peptide. 21 The results above confirm the difference in insulin resistance in GDM with the role of cortisol and serum lipids.…”

“…From these values, we calculated the HOMA2-IR, QUICKI, Mathew, and McAuley indices as described in the previous studies. 21 According to WHO guidelines, the oral glucose tolerance test with 75 grams of anhydrous glucose (OGTT) was performed on the same day of the clinical visit). Serum glucose was assessed at three-time points, including fasting (8 a.m.), 1 hour, and 2 hours afterward.…”

Fatty acids and their metabolites (resolvins) are altered in women with gestational diabetes mellitus (GDM)

“…37 In contrast, no difference in total SFAs has been reported by a cross-sectional study between GDM ( n = 61) and non-GDM ( n = 746) women at 24–28 weeks of gestation. 38 Higher SFA levels have been shown to reduce insulin sensitivity through a defect in insulin signalling in non-pregnant adults, 39 and decreased insulin sensitivity is known to be associated with GDM, 40 suggesting the role of SFAs in the pathophysiology of GDM. Since, delta-9 desaturase ( i.e.…”

Low-Grade Inflammation in Gestational Diabetes Mellitus and Its Correlation with Maternal Insulin Resistance and Fetal Growth Indices

“…Insulin resistance indices, namely Homeostasis Model Assessment (HOMA)2-insulin resistance (IR), McAuley, Mathews, and quantitative Insulin Sensitivity Check Index (QUICKI) indices, were measured as previously described. 19 All study participants were tested with OGTT with 75 grams of anhydrous glucose immediately after venipuncture on the examination day. Venous blood glucose levels were measured at 1 hour and 2 hours after OGTT.…”