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Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis

Title: Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis
Authors: Francis; EC; Powe; CE; Lowe; WL; White; SL; Scholtens; DM; Yang; J; Zhu; Y; Zhang; C; Hivert; MF; Kwak; SH; Sweeting; A; Franks; PW; Rich; SS; Wagner; R; Vilsbøll; T; Vesco; KK; Udler; MS; Tuomi; Sims; EK; Sherr; JL; Semple; RK; Reynolds; RM; Redondo; MJ; Redman; LM; Pratley; RE; Pop-Busui; Pollin; TI; Perng; W; Pearson; ER; Ozanne; SE; Owen; KR; Oram; Murphy; Mohan; V; Misra; S; Meigs; JB; Mathioudakis; N; Mathieu; Ma; RCW; Loos; RJF; Lim; Laffel; Josefson; Hood; Hirsch; IB; Hattersley; AT; Griffin; K; Greeley; SAW; Gottlieb; PA; Gomez; Gloyn; AL; Florez; JC; Dennis; JM; Costacou; Boyle; Billings; LK; Brown; RJ; Philipson; LH; Nolan; JJ; Eckel; RH; Sherifali; D; Mixter; E; Mekonnen; EG; Gruber; Fawcett; AJ; de Souza; Auh; Saint-Martin; Provenzano; M; Pomares-Millan; H; Njølstad; PR; Nakabuye; Molnes; McGovern; Maloney; KA; Flanagan; de Franco; Aukrust; I; Polak; Beltrand; Zhou; SJ; Yu; G; Hannah; Wentworth; Vatier; Van der Schueren; B; Urazbayeva; Ukke; GG; Tye; SC; Taylor; Støy; Stefan; Steck; AK; Steenackers; Stanislawski; MA; Speake; Sheu; WHH; Selvin; Monaco; GSF; Sarkar; Kanbour; Santhakumar; Saeed; Z; Ried-Larsen; Ray; Jain; Quinteros; Petrie; JR; Perez; Pazmino; Pathirana; Pankow; JS; Onengut-Gumuscu; Motala; AA; Morton; RW; Long; SA; Liu; Libman; IM; Leung; GKW; Leong; Koivula; Jones; AG; Johnson; Hoag; Ismail; HM; Harris-Kawano; Huang; Hansen; Habibi; Guasch-Ferré; Grieger; JA; Goodarzi; MO; Gitelman; Fitzpatrick; Fitipaldi; Fernández-Balsells; MM; Evans-Molina; Dudenhöffer-Pfeifer; DiMeglio; LA; Dickens; LT; Deutsch; Dawed; AY; Dabelea; Clemmensen; Chivers; Chikowore; Cheng; F; Chen; Bonham; MP; Andersen; MK; Amouyal; Young; Yamamoto; Wong; Wang; CC; Wallace; AS; Tosur; Thuesen; ACB; Tam; CHT; Takele; WW; Svalastoga; P; Sevilla-Gonzalez; Semnani-Azad; Schön; Rooney; MR; Raghavan; Prystupa; Pilla; Patel; Ozkan; Naylor; RN; Most; Morieri; ML; Miller; RG; McLennan; NM; Massey; Männistö; JME; LL; Kreienkamp; Kettunen; JLT; Kahkoska; AR; Jacobsen; Ikle; Hughes; Haider; Gaillard; Gingras; Gillard; Felton; Duan; Cromer; Corcoy; Colclough; Clark; Bodhini; Benham; Aiken; Ahmad; Merino; Tobias; DK
Contributors: Institute of Molecular and Genomic Medicine
Publisher Information: SPRINGERNATURE
Publication Year: 2023
Collection: National Health Research Institutes (NHRI): Institutional Repository / 國家衛生研究院機構典藏
Description: Background: Perinatal outcomes vary for women with gestational diabetes mellitus (GDM). The precise factors beyond glycemic status that may refine GDM diagnosis remain unclear. We conducted a systematic review and meta-analysis of potential precision markers for GDM. Methods: Systematic literature searches were performed in PubMed and EMBASE from inception to March 2022 for studies comparing perinatal outcomes among women with GDM. We searched for precision markers in the following categories: maternal anthropometrics, clinical/sociocultural factors, non-glycemic biochemical markers, genetics/genomics or other -omics, and fetal biometry. We conducted post-hoc meta-analyses of a subset of studies with data on the association of maternal body mass index (BMI, kg/m2) with offspring macrosomia or large-for-gestational age (LGA). Results: A total of 5905 titles/abstracts were screened, 775 full-texts reviewed, and 137 studies synthesized. Maternal anthropometrics were the most frequent risk marker. Meta-analysis demonstrated that women with GDM and overweight/obesity vs. GDM with normal range BMI are at higher risk of offspring macrosomia (13 studies [n = 28,763]; odds ratio [OR] 2.65; 95% Confidence Interval [CI] 1.91, 3.68), and LGA (10 studies [n = 20,070]; OR 2.23; 95% CI 2.00, 2.49). Lipids and insulin resistance/secretion indices were the most studied non-glycemic biochemical markers, with increased triglycerides and insulin resistance generally associated with greater risk of offspring macrosomia or LGA. Studies evaluating other markers had inconsistent findings as to whether they could be used as precision markers. Conclusions: Maternal overweight/obesity is associated with greater risk of offspring macrosomia or LGA in women with GDM. Pregnancy insulin resistance or hypertriglyceridemia may be useful in GDM risk stratification. Future studies examining non-glycemic biochemical, genetic, other -omic, or sociocultural precision markers among women with GDM are warranted.
Document Type: article in journal/newspaper
File Description: 1208565 bytes; application/pdf
Language: English
Relation: Communications Medicine. 2023 Dec 18;3:Article number 185.; http://ir.nhri.org.tw/handle/3990099045/16149; http://ir.nhri.org.tw/bitstream/3990099045/16149/1/SCP85196233977.pdf
DOI: 10.1038/s43856-023-00393-8
Availability: http://ir.nhri.org.tw/handle/3990099045/16149; https://doi.org/10.1038/s43856-023-00393-8; http://ir.nhri.org.tw/bitstream/3990099045/16149/1/SCP85196233977.pdf
Accession Number: edsbas.FC9558D3
Database: BASE