RESUMO
Background: The prevalence of hyperglycemia first detected during pregnancy is showing an escalating increase in recent years contributed by the increasing obesity prevalence, advanced maternal age at delivery, and the universal screening protocol during the first antenatal visit. There exists a very little data on the role of HbA1c in pregnancy and the results remain inconsistent. There is a need to define diagnostic criteria to predict the adverse perinatal outcomes in gestational diabetes mellitus (GDM). Aims and Objectives: This study was aimed to assess the role of HbA1c as a prognostic indicator of third trimester mean blood glucose in GDM pregnancies and in predicting the birth of large for gestational age (LGA) babies. Materials and Methods: 200 pregnant women with GDM and 200 pregnant women without GDM and their neonates participated in this analytical cross-sectional study. Maternal age, height, weight, BMI, and neonatal birth weight were recorded. Third trimester maternal HbA1c level was analyzed by high-performance liquid chromatography. The association between HbA1c and LGA births was analyzed. Results: The mean HbA1c levels and percentage of LGA births were high in GDM group. Multiple logistic regression analysis showed association between high HbA1c values and LGA births in GDM. A Receiver operating characteristic curve was drawn to derive the optimal cut-off value, sensitivity, and specificity of HbA1c in predicting birth of LGA neonates in GDM. Conclusion: This study shows that high third trimester HbA1c levels in GDM increase the risk of LGA births. Further studies are needed to define standard cut-off values of glycated Hb in each trimester of pregnancy.
RESUMO
Background: Men and women show differences in the distribution of body fat. Women tend to store more fat subcutaneously compared to men. Fat distribution changes in postmenopausal women. Understanding the changes in anthropometry with age and menopausal status is important in the context of deriving population, age, and gender-specific cutoff levels for obesity indices. Aims and Objectives: This study was conducted with the objectives of measuring Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) in South-Indian women and determining the effect of age and menopause on the anthropometric parameters in non-obese and obese women. Materials and Methods: 290 women between the age group of 30 to 70 years participated in this analytical cross-sectional study. Age and menopausal status were recorded. Anthropometric parameters such as weight, height, WC, and hip circumference were measured. Body-mass index, WHR, and WHtR were derived. The data were analyzed to compare mean values of anthropometric parameters between premenopausal and postmenopausal women using unpaired t-test. The difference in anthropometric status was also compared between those with Body mass index (BMI) in the non-obese range and those with BMI in the obese range in relation to menopausal status. Results: A higher proportion of women were classified as having abdominal obesity based on WHtR cutoff compared to classifying using WC cutoff. Postmenopausal women showed higher mean values of all measured anthropometric parameters, but the difference was significant only for WHR. When the study subjects were analyzed based on BMI categories, a significant difference between pre and post-menopausal women was recorded in WHtR values in the non-obese BMI group, but not in the obese BMI group when analyzed by unpaired t-test. Conclusion: Anthropometric parameters show an increasing trend as age advances. There is a difference in mean values of all parameters between pre and post-menopausal women, though statistical significance was seen only for WHR and WHtR in different sub-groups based on BMI. Further studies are needed to decide on the need for separate cutoff values for postmenopausal women.
RESUMO
Background: The prevalence of obesity is increasing in developing countries like India. This will place a great burden on the health infrastructure of the country. Early identification and intervention are the keys to managing this important problem. Since Asians tend to have more visceral body fat for any given body mass index (BMI), lower cut-off values have been suggested for different anthropometric parameters. Studies determining the correlation of Sagittal abdominal diameter (SAD) and SAD-height ratio (SADHtR) with total visceral fat volumes measured by computed tomography (CT) scan abdomen quantification are limited in the South Indian population. Aims and Objectives: This study was conducted with the objectives of measuring BMI, SAD, SADHtR, and comparing the correlation of the measured anthropometric parameters with visceral and subcutaneous abdominal fat volumes measured using CT scan abdomen in both the genders in South Indian population. Materials and Methods: This analytical cross-sectional study was done in a hospital setting with a sample size of 566 (276 men and 290 women-aged 30–70 years). Weight, height, and BMI were measured. SAD was measured electronically from a CT image at the L4–L5 level. SADHtR was derived. Total abdominal fat volumes, subcutaneous abdominal fat volumes, and visceral abdominal fat volumes were measured in cm3 from the dome of the liver to the pubic symphysis using software for CT-based quantification of fat volumes between ?190 and ?30 Hounsfield units threshold limits. The data were tabulated and analyzed to compare mean values between men and women and to find the correlation between the anthropometric parameters and visceral fat volume using Pearson’s correlation test. Results: The difference in mean values of BMI, SAD, and SADHtR between the sexes was statistically significant. SAD showed the highest correlation with visceral fat volume in both genders. BMI showed a higher correlation with subcutaneous adipose tissue volume than with visceral adipose tissue volume. Conclusion: Both SAD and SADHtR can be used as simple and reproducible anthropometric tools to identify the presence of increased visceral fat volume in both genders in our population.