- Metabolic Risk/Epidemiology
- Fetal Abdominal Obesity Detected At 24 to 28 Weeks of Gestation Persists Until Delivery Despite Management of Gestational Diabetes Mellitus
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Wonjin Kim, Soo Kyung Park, Yoo Lee Kim
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Diabetes Metab J. 2021;45(4):547-557. Published online March 5, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0078
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Abstract
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- Background
Fetal abdominal obesity (FAO) has been reported to be affected at gestational diabetes mellitus (GDM) diagnosis at 24 to 28 weeks of gestation in older and/or obese women. This study investigated whether the management of GDM improves FAO in GDM subjects near term.
Methods Medical records of 7,099 singleton pregnant women delivering at CHA Gangnam Medical Center were reviewed retrospectively. GDM was diagnosed by 100-g oral glucose tolerance test after 50-g glucose challenge test based on Carpenter–Coustan criteria. GDM subjects were divided into four study groups according to maternal age and obesity. FAO was defined as ≥90th percentile of fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per actual GA by the last menstruation period, biparietal diameter, or femur length, respectively.
Results As compared with normal glucose tolerance (NGT) subjects near term, FAORs and odds ratio for FAO were significantly higher in old and/or obese women with GDM but not in young and nonobese women with GDM. For fetuses of GDM subjects with FAO at the time of GDM diagnosis, the odds ratio for exhibiting FAO near term and being large for GA at birth were 7.87 (95% confidence interval [CI], 4.38 to 14.15) and 10.96 (95% CI, 5.58 to 20.53) compared with fetuses of NGT subjects without FAO at GDM diagnosis.
Conclusion Despite treatment, FAO detected at the time of GDM diagnosis persisted until delivery. Early diagnosis and treatment might be necessary to prevent near term FAO in high-risk older and/or obese women.
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Citations
Citations to this article as recorded by
- Gestational diabetes mellitus management according to ultrasound fetal growth versus strict glycemic treatment in singleton pregnancies: A systematic review and meta‐analysis of clinical trials
Ana M. Fernández‐Alonso, Angélica Monterrosa‐Blanco, Álvaro Monterrosa‐Castro, Faustino R. Pérez‐López Journal of Obstetrics and Gynaecology Research.2024;[Epub] CrossRef - The effects of gestational diabetes mellitus on fetal growth: is it different for low-risk and medium–high-risk pregnant women?
Jie Wang, Xin Cheng, Zhen-Hua Li, Yi-Cheng Mao, Xin-Qiang Wang, Kang-Di Zhang, Wen-Jie Yu, Ying-Qing Li, Jia-wen Zhao, Mao-Lin Chen, Guo-peng Gao, Cheng-Yang Hu, Xiu-Jun Zhang Archives of Gynecology and Obstetrics.2023; 310(2): 833. CrossRef - Fetal abdominal obesity and the ensuing adverse perinatal outcomes in older obese pregnant women with or without obesity and with normal glucose tolerance
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim Scientific Reports.2023;[Epub] CrossRef - Early-life exposure to gestational diabetes mellitus predisposes offspring to pediatric nonalcoholic fatty liver disease
Qian-Ren Zhang, Yan Dong, Jian-Gao Fan Hepatobiliary & Pancreatic Diseases International.2023;[Epub] CrossRef - Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis
Wenrui Ye, Cong Luo, Jing Huang, Chenglong Li, Zhixiong Liu, Fangkun Liu BMJ.2022; : e067946. CrossRef - Fetal abdominal overgrowth is already present at 20–24 gestational weeks prior to diagnosis of gestational diabetes mellitus
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim Scientific Reports.2021;[Epub] CrossRef
- The Glycated Albumin to Glycated Hemoglobin Ratio Might Not Be Associated with Carotid Atherosclerosis in Patients with Type 1 Diabetes
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Wonjin Kim, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
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Diabetes Metab J. 2014;38(6):456-463. Published online December 15, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.6.456
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Abstract
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- Background
The ratio of glycated albumin to glycated hemoglobin (GA/A1c) is known to be elevated in subjects with type 2 diabetes mellitus (T2DM) who had decreased insulin secretion. Additionally, the carotid intima media thickness (IMT) is greater in T2DM patients with higher GA/A1c ratios. We investigated whether increased GA/A1c ratio and IMT are also associated in type 1 diabetes mellitus (T1DM), which is characterized by lack of insulin secretory capacity. MethodsIn this cross-sectional study, we recruited 81 T1DM patients (33 men, 48 women; mean age 44.1±13.0 years) who underwent carotid IMT, GA, and HbA1c measurements. ResultsThe mean GA/A1c ratio was 2.90. Based on these results, we classified the subjects into two groups: group I (GA/A1c ratio <2.90, n=36) and group II (GA/A1c ratio ≥2.90, n=45). Compared with group I, the body mass indexes (BMIs), waist circumferences, and IMTs were lower in group II. GA/A1c ratio was negatively correlated with BMI, urine albumin to creatinine ratio (P<0.001 for both), and both the mean and maximal IMT (P=0.001, both). However, after adjusting the confounding factors, we observed that IMT was no longer associated with GA/A1c ratio. ConclusionIn contrast to T2DM, IMT was not significantly related to GA/A1c ratio in the subjects with T1DM. This suggests that the correlations between GA/A1c ratio and the parameters known to be associated with atherosclerosis in T2DM could be manifested differently in T1DM. Further studies are needed to investigate these relationships in T1DM.
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