Central obesity in early pregnancy represented a high‐risk phenotype for gestational diabetes mellitus (GDM) independent of other risk factors, including overweight or obesity, and may inform early screening and prevention strategies. This according to a recent study that examined the associations of central obesity measures, waist to hip ratio (WHR) and waist circumference (WC), in early pregnancy with subsequent risk of GDM and evaluated the potential mediating role of insulin resistance markers. Within the prospective Pregnancy Environment and Lifestyle Study cohort of 1,750 women, WC and hip circumference were measured at gestational weeks 10 to 13. In a nested case‐control study within the cohort, 115 GDM cases and 230 controls had fasting serum insulin, homeostatic model assessment of insulin resistance (HOMA‐IR), and adiponectin measurements at gestational weeks 16 to 19. Researchers found:
- For women with WHR < 0.85, ≥1 established risk factors increased GDM risk 1.99‐fold.
- For women with WHR ≥ 0.85 but no established risk factors, GDM risk increased 2.41‐fold, and in those with established risk factors it increased 6.22‐fold.
Zhu Y, Hedderson MM, Quesenberry CP, Feng J, Ferrara A. Central obesity increases the risk of gestational diabetes partially through increasing insulin resistance. [Published online ahead of print November 21, 2018]. Obesity. doi:10.1002/oby.22339.