Study On Relationship Between Body Composition Changes And Gestational Diabetes Mellitus In Early And Middle Pregnancy

Objective:To study the changes of body composition during early and middle pregnancy and the relationship between body composition during pregnancy and Gestational diabetes mellitus(GDM),in order to provide evidence for the prevention of GDM.Methods:From December 15,2020 to December 1,2021,475 pregnant women who delivered in the Affiliated Hospital of North Sichuan Medical College and underwent body composition measurement during early and middle pregnancy were selected as the research objects.According to the GDM diagnostic standard[1]recommended by the International Association of the Diabetes and Pregnancy Study Groups(IADPSG),pregnant women meeting the diagnostic criteria of GDM were selected as the case group(94 cases),and healthy pregnant women who did not meet the diagnostic criteria of GDM were selected as the control group(381 cases),to explore the relationship between body composition changes of pregnant women in early and middle pregnancy and GDM.Results:1.There were statistically significant differences in body fat percentage,body fat mass,fat-free body mass,inorganic salts,muscle mass,protein,total body water,intracellular and extracellular fluid and basal metabolic rate between GDM pregnant women in middle pregnancy and early pregnancy(P<0.05).There were statistically significant differences in body fat percentage,body fat mass,fat-free body mass,inorganic salts,muscle mass,protein,total body water,intracellular and extracellular fluid and basal metabolic rate between healthy pregnant women in middle pregnancy and early pregnancy(P<0.05).2.Without matching age,pre-pregnancy body mass index(BMI),gestational weight gain and times of pregnancy and childbirth,there were statistically significant differences in body fat percentage,body fat mass,basal metabolic rate,inorganic salts and extracellular fluid between the GDM group and the control group in early pregnancy(P<0.05),while there were no statistically significant differences in fat-free body mass,muscle mass,protein,total body water and intracellular fluid between the GDM group and the control group(P>0.05).There were statistically significant differences in body fat percentage,body fat mass,basal metabolic rate and inorganic salts between the GDM group and the control group during middle pregnancy(P<0.05),while there were no statistically significant differences in fat-free body mass,muscle mass,protein,total body water and intracellular and extracellular fluid(P>0.05).After age,pre-pregnancy BMI,gestational weight gain and times of pregnancy and childbirth were matched,there were only significant differences in body fat percentage and body fat mass between GDM group and control group in early and middle pregnancy(P<0.05).There was no significant difference in basal metabolic rate,fat-free body mass,inorganic salt,muscle mass,protein,total body water and intracellular and extracellular fluid(P>0.05).3.Multivariate Logistic regression analysis of GDM showed that age(OR=1.072,1.011-1.137,P=0.019)and body fat mass in early pregnancy(OR=1.098,95%CI:1.057-1.140,P<0.001)were independent risk factors for GDM.Further,the receiver operating characteristic(ROC)curve analysis of body fat mass in early pregnancy showed that the sensitivity was 73.4%,the specificity was 60.6%,the diagnostic threshold was 17.31kg,and the area under the curve(AUC)was 0.682.Conclusion:1.The body composition of healthy and GDM pregnant women increased with the increase of gestational age.2.Compared with healthy pregnant women,the increase of body mass of GDM pregnant women in early and middle pregnancy is mainly the increase of body fat mass.3.Age and body fat mass during early pregnancy are independent risk factors for GDM,and body fat mass during early pregnancy has certain predictive value for GDM.