Predictors of Gestational Diabetes Mellitus Among Antenatal Population in a Tertiary Hospital: Role of Biomarkers of Insulin Resistance

Ugwu SB; Ugwu I; Ekpe EL; Iklaki CS; Emechebe C; Ekpe E; Essien S

doi:10.61386/imj.v19i3.1182

Authors

Ugwu SB Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Nigeria
Ugwu I Coventry, West Midlands, United Kingdom
Ekpe EL Department of Chemical Pathology, University of Calabar, Calabar, Nigeria
Iklaki CS Department of Chemical Pathology, University of Calabar, Calabar, Nigeria
Emechebe C Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Nigeria
Ekpe E Department of Mass Communication, University of Calabar, Calabar, Nigeria
Essien S Department of Chemical Pathology, University of Uyo, Uyo, Nigeria

DOI:

https://doi.org/10.61386/imj.v19i3.1182

Keywords:

Gestational Diabetes Mellitus, Insulin Resistance, Predictors, Prevalence, Biomarkers, HOMA-IR, HOMA-β

Abstract

Context: Gestational Diabetes Mellitus (GDM) is any degree of impaired glucose tolerance with onset or first recognition during pregnancy. This condition affects many pregnancies and has its varied complications for both mother and child. This study aims to analyse the role of biomarkers of insulin resistance in GDM among women attending antenatal care (ANC) clinic at the University of Calabar Teaching Hospital (UCTH), Calabar.

Materials and Methods: A total of 180 pregnant women between 24 and 28 weeks of gestation attending ANC at UCTH Calabar were enrolled for the study. After obtaining ethical approval and informing the women, participants who consented had OGTT done by administration of 75g of glucose after a 12-hour overnight fast.Samples were collected and assayed for fasting plasma insulin, fasting plasma glucose, triglycerides, total cholesterol, HOMA-IR, and HOMA-β. A well-structured questionnaire containing information on demographic characteristics, socioeconomic status, and obstetric and gynaecological characteristics were obtained and assessed for association with biochemical findingsA p-value of less than 0.05 was considered significant .

Results: Out of the 180 women enrolled in the study, most were either overweight (38.3%) or obese (38.9%). Most of the women with GDM were primigravida (40%) and para 1 (37.3%), had previous caesarean section (52.8%), previous preterm delivery (95.4%), and previous stillbirth (45.8%). Based on risk factor assessment, ironically, 45.6% (majority) of women with GDM were of low risk, 29.5% of average risk, and 13.2% of high risk. Elevated fasting plasma glucose (FPG) was found in 30.6%, fasting plasma insulin (FPI) in 41.1%, triglycerides (TG) in 11.1%, total cholesterol (TC) in 51.1%, and insulin resistance index (HOMA-IR) in 67.8%. Of these biomarkers, FPG (p = 0.000) and HOMA-IR (p = 0.004) were found to be significantly associated with the development of GDM.

Conclusion: Insulin resistance index (HOMA-IR) and fasting plasma glucose (FPG) were significantly related to the development of GDM.