The hypertriglyceridemic waist phenotype and glucose intolerance in pregnancy

Background: Abdominal visceral adiposity in early pregnancy has been associated with impaired glucose tolerance in later pregnancy. The hypertriglyceridemic waist phenotype (i.e., abdominal obesity in combination with hypertriglyceridemia) is a clinical marker of visceral obesity. Our study aimed to assess the association between the hypertriglyceridemic-waist phenotype in early pregnancy and glucose intolerance in later pregnancy. Methods: Plasma triglycerides and waist girth were measured at 11-14 weeks of gestation among 144 white pregnant women. Glycemia was measured following a 75-g oral glucose tolerance test performed at 24-28 weeks of gestation. Results: A waist girth greater than 85 cm in combination with a triglyceride level >= 1.7 mmol/L in the first trimester was associated with an increased risk of two-hour glucose >= 7.8 mmol/L following the 75-g oral glucose tolerance test (odds ratio [OR] 6.1, p = 0.002). This risk remained significant even after we controlled for maternal age, fasting glucose at first trimester and previous history of gestational diabetes (OR 4.7, p = 0.02). Interpretation: Measurement of waist girth in combination with measurement of triglyceride concentrations in the first trimester of pregnancy could improve early screening for gestational glucose intolerance.