Are short women at risk for gestational diabetes mellitus?

OBJECTIVE The aim of the study was to assess the influence of height variations on the risk of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS We analyzed the medical records of 1830 Caucasian women with GDM and 1011 healthy pregnant women. The following data were collected: age, prior macrosomia, prior GDM, parity, history of type 2 diabetes in first-degree relatives, weight before pregnancy, weight gain during pregnancy, glucose level at the first obstetric visit, results of the glucose challenge test and oral glucose tolerance test (OGTT), HbA1c, and method for treatment of GDM. RESULTS Women with GDM were significantly shorter than the healthy controls (165.7+/-5.6 vs 163.8+/-6.6 cm; P<0.001). The differences in height were not significant between GDM women who required insulin therapy and those treated with diet alone (P=0.12). All the studied variables, including height, were independently associated with GDM. Even after adjustment for confounding variables, height was still associated with GDM (odds ratio 0.958, 95% confidence interval: 0.94-0.97; P<0.00001). In women with GDM diagnosed by 75-g OGTT, we found a significant inverse association of height adjusted for age and pregravid weight with 2-h glucose level (beta=-0.12; P<0.0001). CONCLUSIONS Caucasian women with GDM are shorter than pregnant women without GDM regardless of the diagnostic criteria used or the severity of glucose intolerance. Although height is an independent predictor for GDM, its predictive value for identifying women at risk is relatively low and should not be considered in selective screening for this disease.

[1]  W. Rathmann,et al.  Differences in height explain gender differences in the response to the oral glucose tolerance test , 2008, Diabetic medicine : a journal of the British Diabetic Association.

[2]  T. Welborn,et al.  Differences in height explain gender differences in the response to the oral glucose tolerance test— the AusDiab study , 2008, Diabetic medicine : a journal of the British Diabetic Association.

[3]  Yvonne W. Cheng,et al.  Glucose challenge test: Screening threshold for gestational diabetes mellitus and associated outcomes , 2007, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[4]  W. Leisenring,et al.  Weight characteristics and height in relation to risk of gestational diabetes mellitus. , 2006, American journal of epidemiology.

[5]  T. Erlinger,et al.  Short Stature and the Risk of Adiposity, Insulin Resistance, and Type 2 Diabetes in Middle Age , 2006, Diabetes Care.

[6]  T. Buchanan,et al.  Gestational diabetes mellitus. , 2005, The Journal of clinical investigation.

[7]  Maria T. Mackay,et al.  Gestational diabetes: Is there a relationship between leg length and glucose tolerance? , 2004, Diabetes care.

[8]  S. Ratcliffe,et al.  False-Positive 1-Hour Glucose Challenge Test and Adverse Perinatal Outcomes , 2004, Obstetrics and gynecology.

[9]  S. Del Prato,et al.  Prevalence and risk factors for gestational diabetes assessed by universal screening. , 2003, Diabetes research and clinical practice.

[10]  S. Kahn,et al.  The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of Type 2 diabetes , 2003, Diabetologia.

[11]  D. Lawlor,et al.  The association between components of adult height and Type II diabetes and insulin resistance: British Women's Heart and Health Study , 2002, Diabetologia.

[12]  Xilin Yang,et al.  Gestational diabetes mellitus in women of single gravidity in Tianjin City, China. , 2002, Diabetes care.

[13]  T. Cole,et al.  Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort. , 2002, International journal of epidemiology.

[14]  K. Cruickshank,et al.  High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history, inactivity, or 21st century Europe? , 2001, Diabetes care.

[15]  M. C. Matos,et al.  Gestational diabetes mellitus diagnosed with a 2-h 75-g oral glucose tolerance test and adverse pregnancy outcomes. , 2001, Diabetes care.

[16]  D. Johnston,et al.  Women with a history of gestational diabetes of European and South Asian origin are shorter than women with normal glucose tolerance in pregnancy , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[17]  M. C. Matos,et al.  Short stature and gestational diabetes in Brazil , 2000, Diabetologia.

[18]  M. C. Matos,et al.  Prevalence of gestational diabetes mellitus – do the new WHO criteria make a difference? , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[19]  G. Smith,et al.  Separating in-utero and postnatal influences on later disease , 1999, The Lancet.

[20]  G. Philippou,et al.  Decreased stature in gestational diabetes mellitus , 1998, Diabetologia.

[21]  H. K. Lee,et al.  Short stature in Korean women: a contribution to the multifactorial predisposition to gestational diabetes mellitus , 1998, Diabetologia.

[22]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[23]  R. Hanson,et al.  Breastfeeding and incidence of non-insulin-dependent diabetes mellitus in Pima Indians , 1997, The Lancet.

[24]  P. Gluckman,et al.  Fetal nutrition and cardiovascular disease in adult life , 1993, The Lancet.

[25]  D. Giugliano.  Height and glucose tolerance , 1992, Diabetologia.

[26]  N. Day,et al.  Height and glucose tolerance in adult subjects , 1991, Diabetologia.

[27]  M. Amini,et al.  Effects of gender and height on the oral glucose tolerance test: the isfahan diabetes prevention study. , 2008, The review of diabetic studies : RDS.

[28]  W. Leisenring,et al.  Contribution Weight Characteristics and Height in Relation to Risk of Gestational Diabetes Mellitus , 2007 .

[29]  R. Jarrett,et al.  Height and glucose tolerance , 2004, Diabetologia.

[30]  Margareth,et al.  Gestational diabetes mellitus diagnosed with a 2-h 75-g oral glucose tolerance test and adverse pregnancy outcomes. , 2001, Diabetes care.