Triglyceride glucose-body mass index and the risk of gestational diabetes mellitus: a prospective pregnancy nutrition cohort study

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-21 DOI:10.1016/j.diabres.2025.112901

Lihua Lin , Libo Xu , Jiayi Dong , Libin Song , Xiaoyan Ye , Juan Lin , Chong Miao

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Abstract

Background

The 75 g oral glucose tolerance test (OGTT) fails to identify high-risk gestational diabetes mellitus (GDM) early in pregnancy. The triglyceride-glucose-body mass index (TyG-BMI), an insulin resistance marker, shows promise in predicting metabolic diseases, but hasn’t been studied for GDM before this study.

Methods

This prospective cohort study analyzed 1,704 pregnant women from the Fujian Pregnancy Nutrition Cohort (FPNC) in Southeast China. Associations between first-trimester TyG-BMI and GDM were assessed by linear regression, generalized linear models, mediation, and population attributable fraction (PAF) analyses.

Results

Higher TyG-BMI increased GDM risk dose-dependently (Q4 vs. Q1 RR: GDM = 2.48, IFG = 3.75, IGT = 1.84, IFSG = 13.00). Leukocytes mediated 13.15 % of the association. PAF indicated 28.44 % of GDM and 67.29 % of IFSG cases were attributable to elevated TyG-BMI.

Conclusions

The baseline TyG-BMI in early pregnancy is a robust predictor of GDM and its subtypes. It could be integrated into early pregnancy screening to identify high-risk women before OGTT, enabling earlier interventions. Anti-inflammatory management could be explored for high-risk women with elevated TyG-BMI.

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甘油三酯葡萄糖体重指数与妊娠期糖尿病的风险：一项前瞻性妊娠营养队列研究。

背景：75 g口服糖耐量试验（OGTT）不能识别妊娠早期高危妊娠糖尿病（GDM）。甘油三酯-葡萄糖-体重指数（TyG-BMI）是一种胰岛素抵抗标志物，在预测代谢性疾病方面有希望，但在本研究之前尚未对GDM进行研究。方法：本前瞻性队列研究分析了来自中国东南部福建省妊娠营养队列（FPNC）的1704名孕妇。通过线性回归、广义线性模型、中介和群体归因分数（PAF）分析评估孕早期TyG-BMI与GDM之间的关系。结果：TyG-BMI越高，GDM风险增加的剂量依赖性越大（Q4 vs Q1 RR: GDM = 2.48,IFG = 3.75,IGT = 1.84,IFSG = 13.00）。白细胞介导13.15% %的关联。PAF显示28.44% %的GDM和67.29 %的IFSG病例可归因于TyG-BMI升高。结论：妊娠早期基线TyG-BMI是GDM及其亚型的可靠预测因子。它可以整合到早期妊娠筛查中，在OGTT之前识别高危妇女，从而实现早期干预。TyG-BMI升高的高危女性可探索抗炎管理。

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

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.