The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

Shuoning Song; Yanbei Duo; Yuemei Zhang; Xiaolin Qiao; Jiyu Xu; Jing Zhang; Zhenyao Peng; Yan Chen; Xiaorui Nie; Qiujin Sun; Xianchun Yang; Ailing Wang; Wei Sun; Yong Fu; Yingyue Dong; Zechun Lu; Tao Yuan; Weigang Zhao

doi:10.2147/DMSO.S335364

The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

Diabetes Metab Syndr Obes. 2021 Dec 16:14:4791-4800. doi: 10.2147/DMSO.S335364. eCollection 2021.

Authors

Shuoning Song¹, Yanbei Duo¹, Yuemei Zhang², Xiaolin Qiao³, Jiyu Xu⁴, Jing Zhang⁵, Zhenyao Peng⁶, Yan Chen³, Xiaorui Nie³, Qiujin Sun⁷, Xianchun Yang⁷, Ailing Wang⁸, Wei Sun⁴, Yong Fu¹, Yingyue Dong¹, Zechun Lu⁸, Tao Yuan¹, Weigang Zhao¹

Affiliations

¹ Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
² Department of Obstetrics, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
³ Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
⁴ Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China.
⁵ Department of Laboratory, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
⁶ Department of Dean's Office, Haidian District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
⁷ Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
⁸ National Center for Women and Children's Health, China CDC, Beijing, People's Republic of China.

Abstract

Objective: To evaluate the association of hepatic steatosis index (HSI) in the first trimester and the risk of gestational diabetes mellitus (GDM) as well as large for gestational age (LGA) infant in Chinese women.

Methods: A total of 1082 pregnant women were included in this study. Maternal basic laboratory data, including ALT, AST, FBG, insulin, TG, and HDL-C, were tested during 6-12 weeks of gestation and anthropometric characteristics were monitored during gestation. A 75-g oral glucose tolerance test (OGTT) was conducted at 24-28 weeks of gestation. HSI, nonalcoholic fatty liver disease (NAFLD) liver fat score, triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) and triglyceride-glucose (TyG) index were calculated. Odds ratio with 95% confidence interval for subsequent risk of GDM and LGA by HSI quartiles were assessed by binary logistic regression model. The predictive ability of HSI for GDM and LGA was evaluated by the receiver operating characteristic (ROC) curve analysis and was compared with other indices.

Results: The incidence of GDM and LGA were 22.09% (239/1082) and 10.53% (87/826). HSI was higher in GDM group than in NGT group (median, interquartile range: 30.67, 27.20-35.10 vs 27.98, 25.70-30.82, P<0.001). Incidence of GDM was gradually increased with increasing HSI values. Women in the highest HSI quartile had significantly higher risk of LGA delivery than those in the lowest HSI quartile (P<0.05). The area under the ROC curves of HSI for GDM and LGA were higher than other indices, reaching 0.646 (95%CI: 0.605-0.686) and 0.600 (95%CI: 0.541-0.660), respectively.

Conclusion: Higher HSI was independently associated with higher risk of GDM and LGA in Chinese women. HSI in the first trimester can predict the risk of GDM and LGA.

Keywords: gestational diabetes mellitus; hepatic steatosis index; large for gestational age infant; nonalcoholic fatty liver disease.

Grants and funding

This study was supported by “13th Five-Year” National Science and Technology Major Project for New Drugs under Grant No. 2019ZX09734001 (to Weigang Zhao).