The Area under the Curve (AUC) of Oral Glucose Tolerance Test (OGTT) Could Be a Measure Method of Hyperglycemia in All Pregnant Women

Zhang, Congyue; Wei, Yueguang; Sun, Wei; Yang, Huixia

doi:10.4236/ojog.2019.92019

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…In the current study, we conducted fixed-effects meta-analyses of EWAS investigating associations between continuous maternal glucose, insulin, and area under the curve of glucose (AUC gluc ) measures from an oral glucose tolerance tests (OGTT) conducted during pregnancy and cord blood DNAm. We used AUC gluc as one of our exposures of interest, as glucose measures at different OGTT time points show similar linear associations with health outcomes ( 1 ) and capture both fasting and nonfasting maternal glycemic regulation ( 10 ). The findings from the meta-analyses were subsequently looked up in complementary observational studies for assessment of whether the variation of DNAm at identified CpGs also potentially associated with cardiometabolic traits in children ( 11 ) and adults ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Maternal Glycemic Dysregulation During Pregnancy and Neonatal Blood DNA Methylation: Meta-analyses of Epigenome-Wide Association Studies

et al. 2022

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OBJECTIVE Maternal glycemic dysregulation during pregnancy increases the risk of adverse health outcomes in her offspring, a risk thought to be linearly related to maternal hyperglycemia. It is hypothesized that changes in offspring DNA methylation (DNAm) underline these associations. RESEARCH DESIGN AND METHODS To address this hypothesis, we conducted fixed-effects meta-analyses of epigenome-wide association study (EWAS) results from eight birth cohorts investigating relationships between cord blood DNAm and fetal exposure to maternal glucose (Nmaximum = 3,503), insulin (Nmaximum = 2,062), and area under the curve of glucose (AUCgluc) following oral glucose tolerance tests (Nmaximum = 1,505). We performed lookup analyses for identified cytosine-guanine dinucleotides (CpGs) in independent observational cohorts to examine associations between DNAm and cardiometabolic traits as well as tissue-specific gene expression. RESULTS Greater maternal AUCgluc was associated with lower cord blood DNAm at neighboring CpGs cg26974062 (β [SE] = 0.013 [2.1 × 10−3], P value corrected for false discovery rate [PFDR] = 5.1 × 10−3) and cg02988288 (β [SE]−0.013 [2.3 × 10−3], PFDR = 0.031) in TXNIP. These associations were attenuated in women with GDM. Lower blood DNAm at these two CpGs near TXNIP was associated with multiple metabolic traits later in life, including type 2 diabetes. TXNIP DNAm in liver biopsies was associated with hepatic expression of TXNIP. We observed little evidence of associations between either maternal glucose or insulin and cord blood DNAm. CONCLUSIONS Maternal hyperglycemia, as reflected by AUCgluc, was associated with lower cord blood DNAm at TXNIP. Associations between DNAm at these CpGs and metabolic traits in subsequent lookup analyses suggest that these may be candidate loci to investigate in future causal and mediation analyses.

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Section: Introductionmentioning

confidence: 99%

Maternal Glycemic Dysregulation During Pregnancy and Neonatal Blood DNA Methylation: Meta-analyses of Epigenome-Wide Association Studies

et al. 2022

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“…For example, during a 7‐year follow‐up of first‐degree relatives of type 2 diabetic patients, G‐AUC levels were highly predictive of the future risk of developing diabetes 23 . Another study suggested that G‐AUC may be a measure of gestational diabetes 24 . Interestingly, a recent analysis suggested that pre‐infection glucose control was associated with a risk for severe respiratory complications in COVID‐19 25 .…”

Section: Discussionmentioning

confidence: 99%

“…23 Another study suggested that G-AUC may be a measure of gestational diabetes. 24 Interestingly, a recent analysis suggested that pre-infection glucose control was associated with a risk for severe respiratory complications in COVID-19. 25 The data from the current study suggests that glucose AUC may be more sensitive to glycemic abnormalities than standard OGTT alone.…”

Section: Discussionmentioning

confidence: 99%

The utility of glucose area under the curve from the oral glucose tolerance test as a screening tool for cystic fibrosis‐related diabetes

Gileles‐Hillel

Soesman

Miari

et al. 2022

Pediatric Pulmonology

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Background: Consistently abnormal glucose levels on oral glucose tolerance test (OGTT) are the most effective screening tool for cystic fibrosis-related diabetes (CFRD). However, some cystic fibrosis (CF) patients demonstrate abnormal glucose profiles not reaching levels required for CFRD diagnosis and are, therefore, left untreated. Since CFRD is associated with disease deterioration, early diagnosis and treatment are desirable. Aim: To explore the association between the area under the curve of glucose (G-AUC) obtained during a five-point 2-h standard OGTT and CF disease severity parameters. Methods: All CF patients referred for an annual routine OGTT at the Hadassah CF Center between 2002 and 2018, were included. Disease severity parameters were correlated with the G-AUC. Results: Two hundred forty-two OGTTs were performed in 81 patients (mean age 19.7 ± 9.0 years); 54% were normal, 14% showed impaired glucose tolerance (IGT), 5% had values in the indeterminate range (INDET), 11% had both IGT and INDET and 16% were diagnosed with CFRD. A gradual increase in mean G-AUC was observed among the groups. In multivariate regression models, G-AUC ≥ 295 mg h/dl was independently associated with an increased number of pulmonary exacerbations (PEx). Not all the patients having this value met the CFRD definition. Conclusion: Patients who do not fulfill the criteria for CFRD may have abnormal glucose metabolism identifiable by abnormally high G-AUC values, which may be associated with more PEx. The potential advantage of treating these patients with insulin and the subsequent reduction in PEx needs further investigation.

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“…Kim et al [ 23 ] reported that the AUC for the 100-g OGTT was associated with an increased risk of LGA in GDM. Another study from China demonstrated that a higher AUC for the 75-g OGTT was related to adverse pregnancy outcomes, such as hypertensive disease and macrosomia [ 24 ]. Our study findings are consistent with these results, demonstrating that hyperglycemia itself is an important pitfall for adverse perinatal outcomes though a more meticulous analysis of the OGTT results.…”

Section: Discussionmentioning

confidence: 99%

How Can We Adopt the Glucose Tolerance Test to Facilitate Predicting Pregnancy Outcome in Gestational Diabetes Mellitus?

Kim

Choi

et al. 2021

Endocrinol Metab

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Background:We investigated how 100-g oral glucose tolerance test (OGTT) results can be used to predict adverse pregnancy outcomes in gestational diabetes mellitus (GDM) patients. Methods: We analyzed 1,059 pregnant women who completed the 100-g OGTT between 24 and 28 weeks of gestation. We compared the risk of adverse pregnancy outcomes according to OGTT patterns by latent profile analysis (LPA), numbers to meet the OGTT criteria, and area under the curve (AUC) of the OGTT graph. Adverse pregnancy outcomes were defined as a composite of preterm birth, macrosomia, large for gestational age, low APGAR score at 1 minute, and pregnancy-induced hypertension. Results: Overall, 257 participants were diagnosed with GDM, with a median age of 34 years. An LPA led to three different clusters of OGTT patterns; however, there were no significant associations between the clusters and adverse pregnancy outcomes after adjusting for confounders. Notwithstanding, the risk of adverse pregnancy outcome increased with an increase in number to meet the OGTT criteria (P for trend=0.011); odds ratios in a full adjustment model were 1.27 (95% confidence interval [CI], 0.72 to 2.23), 2.16 (95% CI, 1.21 to 3.85), and 2.32 (95% CI, 0.66 to 8.15) in those meeting the 2, 3, and 4 criteria, respectively. The AUCs of the OGTT curves also distinguished the patients at risk of adverse pregnancy outcomes; the larger the AUC, the higher the risk (P for trend=0.007). Conclusion:The total number of abnormal values and calculated AUCs for the 100-g OGTT may facilitate tailored management of patients with GDM by predicting adverse pregnancy outcomes.

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The Area under the Curve (AUC) of Oral Glucose Tolerance Test (OGTT) Could Be a Measure Method of Hyperglycemia in All Pregnant Women

Cited by 11 publications

References 23 publications

Maternal Glycemic Dysregulation During Pregnancy and Neonatal Blood DNA Methylation: Meta-analyses of Epigenome-Wide Association Studies

Maternal Glycemic Dysregulation During Pregnancy and Neonatal Blood DNA Methylation: Meta-analyses of Epigenome-Wide Association Studies

The utility of glucose area under the curve from the oral glucose tolerance test as a screening tool for cystic fibrosis‐related diabetes

How Can We Adopt the Glucose Tolerance Test to Facilitate Predicting Pregnancy Outcome in Gestational Diabetes Mellitus?

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