Association between neck circumference and glucose tolerance levels at 2-6 months postpartum in women with and without gestational diabetes.

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Archives of Endocrinology Metabolism Pub Date : 2024-06-03 eCollection Date: 2024-01-01 DOI:10.20945/2359-4292-2022-0242

Camila Rodrigues de Souza Carvalho, Patricia Medici Dualib, Juliana Ogassavara, Rosiane Mattar, Sérgio Atala Dib, Bianca de Almeida-Pititto

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Abstract

Objective: To evaluate the association between neck circumference (NC) measured during pregnancy and markers of glucose metabolism measured 2-6 months postpartum in women with overweight/obesity with and without gestational diabetes (GDM).

Subjects and methods: This prospective study enrolled 100 pregnant women (including 50 with GDM) with pregestational body mass index (BMI) ≥ 25 kg and < 40 kg/m². The cohort was stratified according to NC tertiles during pregnancy. Glucose metabolism was assessed in the postpartum period. The association between NC during pregnancy and markers of glucose metabolism postpartum was tested using linear regression analysis.

Results: Participants with NC in the third tertile, compared with those with NC in the second and first tertiles, had higher levels of glycated hemoglobin (HbA1c; 5.6 ± 0.4% versus 5.4 ± 0.3% versus 5.3 ± 0.2%, respectively, p = 0.006), fasting insulin (13.2 ± 6.6 µIU/mL versus 11.1 ± 5.8 µIU/mL versus 9.5 ± 4.9 µIU/mL, respectively, p = 0.035), homeostasis model for insulin resistance (HOMA-IR; 3.1 ± 1.7 versus 2.5 ± 1.3 versus 2.1 ± 1.2, respectively, p = 0.035) and triglyceride-glucose index (TyG; 4.6 ± 0.2 versus 4.5 ± 0.2 versus 4.5 ± 0.3, respectively, p = 0.010). In crude linear regression analysis, NC measured during pregnancy was significantly associated with levels of fasting plasma glucose, 2-hour glucose, HbA1c, log HOMA-IR, and TyG index. The association remained after adjustment for age, family history of diabetes, and number of pregnancies. When adjusted for pregestational BMI and gestational weight gain, NC remained independently associated with fasting plasma glucose and HbA1c levels.

Conclusion: The NC measured during pregnancy was positively associated with worse glucose metabolic profile in the postpartum among women with obesity/overweight with and without GDM. The NC measurement may be a feasible tool for early identification of women at a higher risk of developing type 2 diabetes mellitus.

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患有和未患有妊娠糖尿病的妇女颈围与产后 2-6 个月葡萄糖耐量水平之间的关系。

目的评估妊娠期测量的颈围（NC）与产后 2-6 个月测量的糖代谢指标之间的关系：这项前瞻性研究共招募了 100 名孕妇（包括 50 名妊娠糖尿病患者），她们的孕前体重指数（BMI）≥ 25 kg 和 < 40 kg/m²。研究人员根据怀孕期间的 NC tertiles 对组群进行了分层。产后对葡萄糖代谢进行了评估。使用线性回归分析检验了孕期NC与产后葡萄糖代谢指标之间的关系：结果：与第二和第一分位数的 NC 患者相比，第三分位数的 NC 患者的糖化血红蛋白（HbA1c；分别为 5.6 ± 0.4% 对 5.4 ± 0.3% 对 5.3 ± 0.2%，p = 0.006）、空腹胰岛素（13.2 ± 6.6 µIU/mL 对 11.1 ± 5.8 µIU/mL 对 9.5 ± 4.9 µIU/mL ，p = 0.035）、胰岛素抵抗稳态模型（HOMA-IR；分别为 3.1 ± 1.7 对 2.5 ± 1.3 对 2.1 ± 1.2，p = 0.035）和甘油三酯-葡萄糖指数（TyG；分别为 4.6 ± 0.2 对 4.5 ± 0.2 对 4.5 ± 0.3，p = 0.010）。在粗线性回归分析中，孕期测量的 NC 与空腹血浆葡萄糖、2 小时血糖、HbA1c、对数 HOMA-IR 和 TyG 指数的水平显著相关。在对年龄、糖尿病家族史和妊娠次数进行调整后，这种关联性依然存在。在对孕前体重指数和妊娠体重增加进行调整后，NC 仍与空腹血浆葡萄糖和 HbA1c 水平独立相关：结论：在患有或未患有 GDM 的肥胖/超重妇女中，孕期测量的 NC 与产后葡萄糖代谢状况的恶化呈正相关。NC测量可能是一种可行的工具，可用于早期识别罹患2型糖尿病风险较高的妇女。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Endocrinology Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

2.90

自引率

5.90%

发文量

107

审稿时长

7 weeks

期刊介绍： The Archives of Endocrinology and Metabolism - AE&M – is the official journal of the Brazilian Society of Endocrinology and Metabolism - SBEM, which is affiliated with the Brazilian Medical Association. Edited since 1951, the AE&M aims at publishing articles on scientific themes in the basic translational and clinical area of Endocrinology and Metabolism. The printed version AE&M is published in 6 issues/year. The full electronic issue is open access in the SciELO - Scientific Electronic Library Online e at the AE&M site: www.aem-sbem.com. From volume 59 on, the name was changed to Archives of Endocrinology and Metabolism, and it became mandatory for manuscripts to be submitted in English for the online issue. However, for the printed issue it is still optional for the articles to be sent in English or Portuguese. The journal is published six times a year, with one issue every two months.