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Mediating effects of body composition at the first trimester on the occurrence of GDM at the early stage of the third trimester during the advanced maternal age

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

To retrospectively analyze the mediating effects of body composition during the first trimester on the occurrence of gestational diabetes mellitus (GDM) in early third trimester in advanced maternal age (AMA).

Methods

From December 2017 to May 2018, 1635 singleton pregnant women who underwent delivery in the Guiyang Maternal and Child Health Hospital were selected. The body composition data was measured by using the INBODY770 body composition instrument in the first trimester (mainly at a gestational age of 10–12 weeks). The blood glucose levels at fasting for one night and the cutoff values for them at 1 and 2 h after administration during the 75 g oral glucose tolerance test at gestational age of 24–28 weeks (the early stage of the 3rd trimester) were also collected. According to the Baron and Kenny’s criteria (the basic principle of interpreting the intermediary role), multivariate logistic regression was used to analyze the mediating effects of body composition (body fat percentage and protein percentage) between AMA and GDM occurrence.

Results

In total, 1635 subjects aged 30.93 ± 4.80 years were selected, and there were 376 women with AMA (23%). There were 983 pregnant women (39.88%) with a body fat percentage greater than 30% and 1331 (81.71%) pregnant women with a protein percentage less than 15%. The results showed significant differences in height, weight, lean body weight, body fat, body fat percentage, and GDM prevalence between AMA and low-age groups (p < 0.05). After adjusting height, parity, and AMA, the body fat percentage showed association with GDM (odds ratio, OR 1.85 (1.38 ~ 2.48); confidence interval, CI 95%, p < 0.05). After adjusting height, parity, and body weight percentage, the AMA showed association with GDM (OR (CI95%) 2.38 (1.68 ~ 3.37)). Similarly, the protein percentage showed association with GDM (OR (CI 95%) 0.50 (0.31 ~ 0.81), p < 0.05).

Conclusion

These results confirmed the mediating effects of body fat percentage and protein percentage on AMA and the occurrence of GDM. Advanced age is directly associated with increased risk of GDM, which in turn increases with higher percentage of body fat and lower percentage of protein.

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Acknowledgments

We thank Guizhou University of Chinese Traditional Medicine and Guiyang Maternal and Child Health Hospital for their help and support. We also thank the women who participated in this study for their contribution and time.

Funding

This work was financed by grants from the Natural Science Foundation of China (81760336) and Guizhou Health Commission (Gzwjkj2018-1-079).

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Author notes

  1. Liu Jing and Zheng Dan contributed equally to this work.

Authors and Affiliations

  1. School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, Guizhou, People’s Republic of China

    Liu Jing, Zheng Dan, Lu Yang, Yin Xuan & Lou Didong

  2. Guiyang Maternal and Child Health Hospital, Guizhou, People’s Republic of China

    Liu Jing, Zheng Dan, Lu Yang & Yin Xuan

  3. Department of Nutrition and Food Hygiene, Guizhou Medical University, Guizhou, People’s Republic of China

    Wang Huiqun

  4. Peking Union Medical College Hospital, Beijing, People’s Republic of China

    Liu Yanping

  5. Department of Preventive Medicine, Sichuan University, Sichuan, People’s Republic of China

    Zheng Mengmou

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  1. Liu Jing
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Correspondence to Lou Didong.

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The authors declare that they have no conflict of interest.

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The study protocol was approved by the ethics committee of Guiyang Maternal and Child Health Hospital.

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Informed consent was obtained from women who participated.

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Jing, L., Dan, Z., Huiqun, W. et al. Mediating effects of body composition at the first trimester on the occurrence of GDM at the early stage of the third trimester during the advanced maternal age. Int J Diabetes Dev Ctries 41, 121–126 (2021). https://doi.org/10.1007/s13410-020-00845-0

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