The Value of First-trimester Maternal Abdominal Visceral Adipose Tissue Thickness in Predicting the Subsequent Development of Gestational Diabetes Mellitus

Objective: To examine the performance of first-trimester visceral (pre-peritoneal), subcutaneous, and total adipose tissue thickness (ATT) to predict the patients with subsequently developing gestational Diabetes mellitus (GDM). Study Design: Observational study. Place and Duration of Study: Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Training and Research Hospital from January 2021 to July 2021. Methodology: A total of 100 pregnant women underwent sonographic measurement of subcutaneous and visceral ATT at 11-14 weeks' gestation. A 75-g oral glucose tolerance test (OGTT) was conducted between 24-28 weeks of pregnancy for the diagnosis of GDM. Results: The mean visceral, subcutaneous, and total ATT were significantly higher in the GDM group (24.75 +/- 10.34 mm, 26.33 +/- 5.33 mm, 51.08 +/- 14.4 mm) than in the group without a GDM diagnosis (16.68 +/- 6.73 mm, 17.68 +/- 4.86 mm, 34.25 +/- 11.04, respectively, p<0.001). A pre-gestational BMI >30 kg/m(2) (Odds ratio [OR]=10.20, 95% CI=2.519-41.302, p=0.001), visceral ATT (OR=33.2, 95% CI=7.395- 149.046, p< 0.001), subcutaneous ATT (OR=4.543, 95% CI=1.149-17.960, p=0.031), and total ATT (OR=10.895, 95% CI=2.682-44.262, p=0.001) were the factors that were found to be significantly associated with the subsequent development of GDM after adjusting for potential confounders (maternal age, and parity). The most significant risk factor for the prediction of GDM is visceral ATT with an OR of 33.2. Conclusion: US measurement of maternal visceral ATT during first-trimester fetal aneuploidy screening is a reliable, reproducible, cost-effective, and safe method to identify pregnant women at high risk for GDM.