Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It is characterized by normal or possibly impaired glucose metabolism before pregnancy and abnormal glucose metabolism during pregnancy. We evaluate the predictive value of body composition indicators in early pregnancy for GDM. Methods: Pregnant women who visited Huaibei Maternal and Child Health Hospital from November 2022 to April 2023 were selected as study participants. Body composition indicators were measured using bioelectrical impedance assessment at 11–14 weeks of gestation. Study subjects completed a 75-g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Relationships between body composition indicators and GDM were explored using multivariate logistic regression. Additionally, the predictive value of body composition indicators for GDM was assessed through the receiver operating characteristic (ROC) curve and restricted cubic spline (RCS). Results: Five hundred eighty-eight participants were enrolled, 100 of whom had a diagnosis of GDM (17.9%). We found that percent body fat (PBF) and visceral fat index (VFI) were associated with a higher risk of GDM, with adjusting ORs of 1.82 (95% CI = 1.50–2.21) and 6.10 (95% CI = 3.91–9.51) after adjusting for confounders, respectively. The ROC showed that PBF and VFI were highly predictive values for GDM. The RCS displayed that there was a J-shaped connection between 3-point OGTT plasma glucose and PBF. There was a nonlinear relationship between 1-h plasma glucose and VFI. Conclusions: The findings suggest that PBF and VFI have high predictive value for GDM.

1.
Lu
L
,
Wan
B
,
Sun
M
.
Mendelian randomization identifies age at menarche as an independent causal effect factor for gestational diabetes mellitus
.
Diabetes Obes Metab
.
2023
;
25
(
1
):
248
60
.
2.
Jiang
L
,
Tang
K
,
Magee
LA
,
von Dadelszen
P
,
Ekeroma
A
,
Li
X
, et al
.
A global view of hypertensive disorders and diabetes mellitus during pregnancy
.
Nat Rev Endocrinol
.
2022
;
18
(
12
):
760
75
.
3.
Choudhury
AA
,
Devi Rajeswari
V
.
Gestational diabetes mellitus - a metabolic and reproductive disorder
.
Biomed Pharmacother
.
2021
;
143
:
112183
.
4.
Kim
W
,
Park
SK
,
Kim
YL
.
Fetal abdominal obesity detected at 24 to 28 Weeks of gestation persists until delivery despite management of gestational diabetes mellitus
.
Diabetes Metab J
.
2021
;
45
(
4
):
547
57
.
5.
Kim
W
,
Park
SK
,
Kim
YL
.
Fetal abdominal overgrowth is already present at 20–24 gestational weeks prior to diagnosis of gestational diabetes mellitus
.
Sci Rep
.
2021
;
11
(
1
):
23821
.
6.
Kim
W
,
Park
SK
,
Kim
YL
,
Kim
YL
.
Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese women: is it too late
.
PLoS One
.
2019
;
14
(
12
):
e0225955
.
7.
Lyons-Reid
J
,
Ward
LC
,
Kenealy
T
,
Cutfield
W
.
Bioelectrical impedance analysis—an easy tool for quantifying body composition in infancy
.
Nutrients
.
2020
;
12
(
4
):
920
.
8.
Lyons-Reid
J
,
Ward
LC
,
Tint
M-T
,
Kenealy
T
,
Godfrey
KM
,
Chan
SY
, et al
.
The influence of body position on bioelectrical impedance spectroscopy measurements in young children
.
Sci Rep
.
2021
;
11
(
1
):
10346
.
9.
Liao
Y-S
,
Li
H-C
,
Lu
H-K
,
Lai
C-L
,
Wang
Y-S
,
Hsieh
K-C
.
Comparison of bioelectrical impedance analysis and dual energy X-ray absorptiometry for total and segmental bone mineral content with a three-compartment model
.
Int J Environ Res Public Health
.
2020
;
17
(
7
):
2595
.
10.
Branco
MG
,
Mateus
C
,
Capelas
ML
,
Pimenta
N
,
Santos
T
,
Mäkitie
A
, et al
.
Bioelectrical impedance analysis (BIA) for the assessment of body composition in oncology: a scoping review
.
Nutrients
.
2023
;
15
(
22
):
4792
.
11.
Matthews
L
,
Bates
A
,
Wootton
SA
,
Levett
D
.
The use of bioelectrical impedance analysis to predict post-operative complications in adult patients having surgery for cancer: a systematic review
.
Clin Nutr
.
2021
;
40
(
5
):
2914
22
.
12.
Wang
N
,
Sun
Y
,
Zhang
H
,
Chen
C
,
Wang
Y
,
Zhang
J
, et al
.
Total and regional fat‐to‐muscle mass ratio measured by bioelectrical impedance and risk of incident type 2 diabetes
.
J Cachexia Sarcopenia Muscle
.
2021
;
12
(
6
):
2154
62
.
13.
Obuchowska
A
,
Standyło
A
,
Kimber-Trojnar
Ż
,
Leszczyńska-Gorzelak
B
.
The possibility of using bioelectrical impedance analysis in pregnant and postpartum women
.
Diagnostics
.
2021
;
11
(
8
):
1370
.
14.
Han
SJ
,
Boyko
EJ
,
Kim
S-K
,
Fujimoto
WY
,
Kahn
SE
,
Leonetti
DL
.
Association of thigh muscle mass with insulin resistance and incident type 2 diabetes mellitus in Japanese Americans
.
Diabetes Metab J
.
2018
;
42
(
6
):
488
95
.
15.
He
Y
,
Huang
C
,
Luo
B
,
Liao
S
.
Association between maternal body composition in second trimester and risk of fetal macrosomia: a population-based retrospective study in China
.
Nutrients
.
2023
;
15
(
18
):
3879
.
16.
Cremona
A
,
O’Gorman
CS
,
Ismail
KI
,
Hayes
K
,
Donnelly
AE
,
Hamilton
J
, et al
.
A risk-prediction model using parameters of maternal body composition to identify gestational diabetes mellitus in early pregnancy
.
Clin Nutr ESPEN
.
2021
;
45
:
312
21
.
17.
Xintong
L
,
Dongmei
X
,
Li
Z
,
Ruimin
C
,
Yide
H
,
Lingling
C
, et al
.
Correlation of body composition in early pregnancy on gestational diabetes mellitus under different body weights before pregnancy
.
Front Endocrinol
.
2022
;
13
:
916883
.
18.
American Diabetes Association Professional Practice Committee
.
2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2022
.
Diabetes Care
.
2022
;
45
(
Suppl 1
):
S17
38
.
19.
American Diabetes Association Professional Practice Committee
;
Aleppo
G
,
Bannuru
RR
.
2. Diagnosis and classification of diabetes:standards of care in diabetes—2024
.
Diabetes Care
.
2024
;
47
(
Suppl 1
):
S20
42
.
20.
Bastian
B
,
Smithers
LG
,
Pape
A
,
Davis
W
,
Fu
K
,
Francois
M
.
Early screening and diagnosis of gestational diabetes mellitus (GDM) and its impact on perinatal outcomes
.
Diabetes Res Clin Pract
.
2024
;
217
:
111890
.
21.
Saravanan
P
,
Deepa
M
,
Ahmed
Z
,
Ram
U
,
Surapaneni
T
,
Kallur
SD
, et al
.
Early pregnancy HbA1c as the first screening test for gestational diabetes: results from three prospective cohorts
.
Lancet Diabetes Endocrinol
.
2024
;
12
(
8
):
535
44
.
22.
Bertini
A
,
Gárate
B
,
Pardo
F
,
Pelicand
J
,
Sobrevia
L
,
Torres
R
, et al
.
Impact of remote monitoring technologies for assisting patients with gestational diabetes mellitus: a systematic review
.
Front Bioeng Biotechnol
.
2022
;
10
:
10doi
.
23.
Ghanem
YM
,
El Kassar
Y
,
Magdy
MM
,
Amara
M
,
Amin
NG
.
Potential risk of gestational diabetes mellitus in females undergoing in vitro fertilization: a pilot study
.
Clin Diabetes Endocrinol
.
2024
;
10
(
1
):
7
.
24.
Choudhury
AA
,
Rajeswari
VD
.
Polycystic ovary syndrome (PCOS) increases the risk of subsequent gestational diabetes mellitus (GDM): a novel therapeutic perspective
.
Life Sci
.
2022
;
310
:
121069
.
25.
Rodrigo
N
,
Glastras
SJ
.
The emerging role of biomarkers in the diagnosis of gestational diabetes mellitus
.
J Clin Med
.
2018
;
7
(
6
):
120
.
26.
Sun
M
,
Luo
M
,
Wang
T
,
Wei
J
,
Zhang
S
,
Shu
J
, et al
.
Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China
.
BMJ Open Diabetes Res Care
.
2023
;
11
(
2
):
e003324
.
27.
Meng
GL
,
Wang
Q
,
Kang
R
,
Cheng
XY
,
Yang
JL
,
Xie
Y
.
Prevalence of abnormal glucose values and gestational diabetes mellitus among pregnant women in Xi’an from 2015 to 2021
.
BMC Pregnancy Childbirth
.
2023
;
23
(
1
):
471
.
28.
Wang
C
,
Wei
Y
,
Zhang
X
,
Zhang
Y
,
Xu
Q
,
Sun
Y
, et al
.
A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women
.
Am J Obstet Gynecol
.
2017
;
216
(
4
):
340
51
.
29.
Wu
S
,
Jin
J
,
Hu
K-L
,
Wu
Y
,
Zhang
D
.
Prevention of gestational diabetes mellitus and gestational weight gain restriction in overweight/obese pregnant women: a systematic review and network meta-analysis
.
Nutrients
.
2022
;
14
(
12
):
2383
.
30.
Ferrara
A
,
Hedderson
MM
,
Brown
SD
,
Ehrlich
SF
,
Tsai
AL
,
Feng
J
, et al
.
A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial
.
Lancet Diabetes Endocrinol
.
2020
;
8
(
6
):
490
500
.
31.
Champion
ML
,
Harper
LM
.
Gestational weight gain: update on outcomes and interventions
.
Curr Diab Rep
.
2020
;
20
(
3
):
11
.
32.
Goldstein
RF
,
Abell
SK
,
Ranasinha
S
,
Misso
M
,
Boyle
JA
,
Black
MH
, et al
.
Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis
.
Jama
.
2017
;
317
(
21
):
2207
25
.
33.
Sun
Y
,
Shen
Z
,
Zhan
Y
,
Wang
Y
,
Ma
S
,
Zhang
S
, et al
.
Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications
.
BMC Pregnancy Childbirth
.
2020
;
20
(
1
):
390
.
34.
Chen
K
,
Shen
Z
,
Gu
W
,
Lyu
Z
,
Qi
X
,
Mu
Y
, et al
.
Prevalence of obesity and associated complications in China: a cross‐sectional, real‐world study in 15.8 million adults
.
Diabetes Obes Metab
.
2023
;
25
(
11
):
3390
9
.
35.
Wang
Y
,
Zhao
L
,
Gao
L
,
Pan
A
,
Xue
H
.
Health policy and public health implications of obesity in China
.
Lancet Diabetes Endocrinol
.
2021
;
9
(
7
):
446
61
.
36.
Hunt
KJ
,
Ferguson
PL
,
Neelon
B
,
Commodore
S
,
Bloom
MS
,
Sciscione
AC
, et al
.
The association between maternal pre‐pregnancy BMI, gestational weight gain and child adiposity: a racial‐ethnically diverse cohort of children
.
Pediatr Obes
.
2022
;
17
(
8
):
e12911
.
37.
Nakanishi
K
,
Saijo
Y
,
Yoshioka
E
,
Sato
Y
,
Kato
Y
,
Nagaya
K
, et al
.
Severity of low pre-pregnancy body mass index and perinatal outcomes: the Japan Environment and Children’s Study
.
BMC Pregnancy Childbirth
.
2022
;
22
(
1
):
121
.
38.
Li
M
,
Zhang
C-Y
,
Yue
C-Y
.
Effects of pre-pregnancy BMI and gestational weight gain on adverse pregnancy outcomes and complications of GDM
.
J Obstet Gynaecol
.
2022
;
42
(
4
):
630
5
.
39.
Zhao
W
,
Zhang
Q
,
Yang
Z
,
Rao
B
,
Chen
Y
,
Yu
K
, et al
.
Association of differential body water composition by sex, measured using BIA, with survival in a real-world lung cancer cohort
.
Nutrition
.
2022
:
103
4
.
40.
Potter
AW
,
Chin
GC
,
Looney
DP
,
Friedl
KE
.
Defining overweight and obesity by percent body fat instead of body mass index
.
J Clin Endocrinol Metab
.
2024
;
110
(
4
):
e1103
7
.
41.
Zhao
T
,
Lin
Z
,
Zhu
H
,
Wang
C
,
Jia
W
.
Impact of body fat percentage change on future diabetes in subjects with normal glucose tolerance
.
IUBMB Life
.
2017
;
69
(
12
):
947
55
.
42.
Bai
M
,
Susic
D
,
O’Sullivan
AJ
,
Henry
A
.
Reproducibility of bioelectrical impedance analysis in pregnancy and the association of body composition with the risk of gestational diabetes: a substudy of mums cohort
.
J Obes
.
2020
;
2020
:
3128767
12
.
43.
Qin
Z
,
Jiang
L
,
Sun
J
,
Geng
J
,
Chen
S
,
Yang
Q
, et al
.
Higher visceral adiposity index is associated with increased likelihood of abdominal aortic calcification
.
Clinics
.
2022
;
77
:
100114
.
44.
Alwash
SM
,
McIntyre
HD
,
Mamun
A
.
The association of general obesity, central obesity and visceral body fat with the risk of gestational diabetes mellitus: evidence from a systematic review and meta-analysis
.
Obes Res Clin Pract
.
2021
;
15
(
5
):
425
30
.
45.
Yao
D
,
Chang
Q
,
Wu
Q-J
,
Gao
SY
,
Zhao
H
,
Liu
YS
, et al
.
Relationship between maternal central obesity and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies
.
J Diabetes Res
.
2020
;
2020
:
6303820
12
.
46.
Balani
J
,
Hyer
SL
,
Shehata
H
,
Mohareb
F
.
Visceral fat mass as a novel risk factor for predicting gestational diabetes in obese pregnant women
.
Obstet Med
.
2018
;
11
(
3
):
121
5
.
47.
Mijatovic-Vukas
J
,
Capling
L
,
Cheng
S
,
Stamatakis
E
,
Louie
J
,
Cheung
NW
, et al
.
Associations of diet and physical activity with risk for gestational diabetes mellitus: a systematic review and meta-analysis
.
Nutrients
.
2018
;
10
(
6
):
698
.
48.
Wang
Y
,
Pan
X-F
,
Pan
A
.
Lipidomics in gestational diabetes mellitus
.
Curr Opin Lipidol
.
2023
;
34
(
1
):
1
11
.
49.
Furse
S
,
Koulman
A
,
Ozanne
SE
,
Poston
L
,
White
SL
,
Meek
CL
.
Altered lipid metabolism in obese women with gestational diabetes and associations with offspring adiposity
.
J Clin Endocrinol Metab
.
2022
;
107
(
7
):
e2825
32
.
50.
Wang
Y
,
Wu
P
,
Huang
Y
,
Ye
Y
,
Yang
X
,
Sun
F
, et al
.
BMI and lipidomic biomarkers with risk of gestational diabetes in pregnant women
.
Obesity
.
2022
;
30
(
10
):
2044
54
.
51.
Wang
Y
,
Huang
Y
,
Wu
P
,
Ye
Y
,
Sun
F
,
Yang
X
, et al
.
Plasma lipidomics in early pregnancy and risk of gestational diabetes mellitus: a prospective nested case–control study in Chinese women
.
Am J Clin Nutr
.
2021
;
114
(
5
):
1763
73
.
52.
Rahman
ML
,
Feng
Y-CA
,
Fiehn
O
,
Albert
PS
,
Tsai
MY
,
Zhu
Y
, et al
.
Plasma lipidomics profile in pregnancy and gestational diabetes risk: a prospective study in a multiracial/ethnic cohort
.
BMJ Open Diabetes Res Care
.
2021
;
9
(
1
):
e001551
.
You do not currently have access to this content.