Body composition and adipokines in pregnant women: Associations with gestational diabetes mellitus risk

Table 1 Comparison of general data between gestational diabetes mellitus group and normal glucose tolerance group, mean ± SD/n (%)

Variables	GDM group (n = 276)	NGT group (n = 1380)	Test statistic	P value
Age (years)	32.5 ± 5.4	31.8 ± 5.1	t = 1.82	0.069
Height (m)	160.8 ± 6.2	161.1 ± 5.5	t = -0.75	0.453
Pre-pregnancy BMI (kg/m2)	23.6 ± 3.9	22.3 ± 4.8	t = 4.85	< 0.001
Second-trimester weight gain (kg), median (P25, P75)	8.0 (5.2, 10.3)	7.6 (4.8, 9.9)	Z = 1.21	0.226
Parity			χ2 = 3.12	0.210
0	102 (36.9)	558 (40.5)
1	155 (56.2)	690 (50.0)
≥ 2	19 (6.9)	132 (9.5)
FPG (mmol/L)	5.3 ± 0.6	4.7 ± 0.4	t = 12.35	< 0.001
1-hour post-OGTT glucose (mmol/L)	9.7 ± 1.4	7.4 ± 1.3	t = 20.12	< 0.001
2-hour post-OGTT glucose (mmol/L)	8.1 ± 1.4	6.4 ± 1.0	t = 15.87	< 0.001
FINS (mU/L)	0.7 ± 0.4	0.5 ± 0.3	t = 6.51	< 0.001
HOMA-IR	0.06 ± 0.03	0.01 ± 0.01	t = 22.45	< 0.001
ISI	0.0055 ± 0.003	0.0011 ± 0.0004	t = 25.67	< 0.001

GDM: Gestational diabetes mellitus; NGT: Normal glucose tolerance; BMI: Body mass index; FPG: Fasting plasma glucose; OGTT: Oral glucose tolerance test; FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment of insulin resistance; ISI: Insulin sensitivity index.

Table 2 Comparison of body composition components between gestational diabetes mellitus group and normal glucose tolerance group, mean ± SD

Body composition indicator	GDM group (n = 276)	NGT group (n = 1380)	Test statistic	P value
FMP (%)	36.23 ± 7.54	33.12 ± 9.87	t = 5.23	< 0.001
FFMP (%)	60.12 ± 7.23	63.45 ± 9.56	t = -4.89	< 0.001
MP (%)	56.34 ± 6.45	59.23 ± 9.12	t = -4.56	< 0.001
PP (%)	11.54 ± 1.65	12.56 ± 2.43	t = -5.12	< 0.001
ECW/ICW	0.63 ± 0.03	0.61 ± 0.02	t = 4.21	0.012
M/F	1.55 ± 0.49	1.80 ± 0.90	t = -4.32	< 0.001
FMI (kg/m²)	9.87 ± 3.32	8.34 ± 4.11	t = 4.67	< 0.001
BM (kcal)	1587.34 ± 93.21	1565.43 ± 142.34	t = 1.43	0.135

GDM: Gestational diabetes mellitus; NGT: Normal glucose tolerance; BM: Basal metabolism; FMP: Fat mass percentage; FFMP: Fat-free mass percentage; MP: Muscle percentage; PP: Protein percentage; ECW/ICW: Extracellular-to-intracellular water ratio; M/F: Muscle-to-fat ratio; FMI: Fat mass index.

Table 3 Comparison of adipokines between gestational diabetes mellitus group and normal glucose tolerance group

Adipokine	GDM group (n = 276)	NGT group (n = 1380)	Test statistic	P value
Leptin (pg/mL), median (P25, P75)	212.34 (45.56, 620.12)	130.23 (35.45, 860.34)	Z = 2.43	0.014
FABP4 (ng/mL), median (P25, P75)	1.20 (0.03, 1.25)	1.15 (0.22, 1.52)	Z = 0.16	0.872
Adiponectin (ng/mL), median (P25, P75)	11.34 (7.22, 12.45)	12.32 (9.11, 13.33)	Z = -2.32	0.021

GDM: Gestational diabetes mellitus; NGT: Normal glucose tolerance; FABP4: Fatty acid-binding protein 4.

Table 4 Univariate logistic regression analysis of gestational diabetes mellitus risk factors

Variable	B	SE	Wald	P value	OR (95%CI)
Pre-pregnancy BMI	0.145	0.035	17.234	< 0.001	1.452 (1.082-1.233)
FMP	0.092	0.025	13.890	< 0.001	1.093 (1.041-1.142)
FFMP	-0.095	0.026	13.567	< 0.001	0.913 (0.861-0.963)
MP	-0.102	0.028	12.987	< 0.001	0.903 (0.851-0.953)
PP	-0.378	0.102	13.654	< 0.001	0.685 (0.551-0.831)
ECW/ICW	0.385	0.112	12.123	0.001	1.462 (1.181-1.812)
M/F	-0.745	0.245	9.345	0.002	0.474 (0.291-0.782)
FMI	0.195	0.049	15.890	< 0.001	1.215 (1.101-1.342)
Leptin	0.065	0.036	0.987	0.065	0.943 (0.531-1.142)
FABP4	-0.085	0.170	0.245	0.620	0.918 (0.661-1.283)
Adiponectin	-0.032	0.026	1.234	0.265	0.972 (0.921-1.034)

OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; FMP: Fat mass percentage; FFMP: Fat-free mass percentage; MP: Muscle percentage; PP: Protein percentage; ECW/ICW: Extracellular-to-intracellular water ratio; M/F: Muscle-to-fat ratio; FMI: Fat mass index; FABP4: Fatty acid-binding protein 4.

Table 5 Multivariate logistic regression analysis of gestational diabetes mellitus risk factors

Variable	B	SE	Wald	P value	OR (95%CI)
Pre-pregnancy BMI	0.065	0.062	1.123	0.315	1.067 (0.932-1.213)
ECW/ICW elevation	0.090	0.245	0.135	0.720	1.094 (0.681-1.762)
FMP elevation	0.390	0.150	4.567	0.030	1.412 (1.022-1.932)
FMI elevation	-0.015	0.058	0.065	0.800	0.985 (0.881-1.094)

OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; FMP: Fat mass percentage; ECW/ICW: Extracellular-to-intracellular water ratio; FMI: Fat mass index.

Table 6 Correlation analysis of insulin resistance, body composition, and adipokines

Body composition indicator	HOMA-IR (GDM/NGT)	ISI (GDM/NGT)	Leptin (GDM/NGT)	Adiponectin (GDM/NGT)	FABP4 (GDM/NGT)
FMP	0.185/0.152a	-0.201/-0.225a	0.140/-0.188	-0.100/-0.110	0.005/-0.185a
FFMP	-0.212/-0.135a	0.198/0.215a	-0.055/-0.065	0.120/0.095	-0.010/0.182a
MP	-0.210/-0.142a	0.195/0.212a	-0.060/-0.070	0.115/0.098	-0.012/0.190a
PP	-0.225a/-0.140a	0.215a/0.210a	-0.060/-0.070	0.115/0.098	-0.012/0.190a
ECW/ICW	0.098/0.212a	-0.130/-0.170a	-0.048/-0.105	-0.145/-0.142a	0.052/-0.200a
M/F	-0.208/-0.145a	0.192/0.220a	0.135/0.210	0.095/0.215	-0.002/0.198a
FMI	0.220a/0.148a	-0.222a/-0.228a	0.155/-0.192	-0.125/-0.108	0.006/-0.196a

^aP < 0.05.

GDM: Gestational diabetes mellitus; NGT: Normal glucose tolerance; FMP: Fat mass percentage; FFMP: Fat-free mass percentage; MP: Muscle percentage; PP: Protein percentage; ECW/ICW: Extracellular-to-intracellular water ratio; M/F: Muscle-to-fat ratio; FMI: Fat mass index; HOMA-IR: Homeostatic model assessment of insulin resistance; ISI: Insulin sensitivity index; FABP4: Fatty acid-binding protein 4.