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Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort

Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort
We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiver-operating characteristic (AUROC) curves were used to analyze associations of anthropometric (weight, height, waist/hip circumferences, 4-site skinfold thicknesses) and HbA1c z-scores with dysglycemia (fasting glucose ≥6.1 mmol/L with 2-hour glucose ≥7.8 mmol/l). The prevalence of dysglycemia was 10.9%. After adjusting for sociodemographic/medical history, BMI (Odds Ratio [OR] = 1.62 [95%CI 1.32–1.99]), waist-to-height ratio (OR = 1.74 [1.39–2.17]) and total skinfolds (OR = 2.02 [1.60–2.55]) showed the strongest associations with dysglycemia but none outperformed HbA1c (OR = 4.09 [2.81–5.94]). After adjustment for history, adding BMI, waist-to-height ratio and total skinfolds (anthropometry trio) as continuous variables to HbA1c (AUROC = 0.80 [95%CI 0.75–0.85]) performed similarly to HbA1c alone (AUROC = 0.79 [0.74–0.84]). However, using clinically-defined thresholds without considering history, as in common clinical practice, BMI ≥ 23 kg/m2 + HbA1c ≥ 5.7% (AUROC = 0.70 [0.64–0.75]) and anthropometry trio + HbA1c ≥ 5.7% (AUROC = 0.71 [0.65–0.76]) both outperformed HbA1c ≥ 5.7% alone (AUROC = 0.61 [0.57–0.65]). In a two-stage strategy, incorporating BMI ≥ 23 kg/m2 alongside HbA1c ≥ 5.7% into first-stage screening to identify high risk women for subsequent oral glucose tolerance testing improves dysglycemia detection in Asian women preconception.
2045-2322
Chu, Anne H.Y.
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Aris, I.M.
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Ng, Sharon
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Bernard, Jonathan Y.
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Mya, Tint
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Yuan, Wen Lun
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Godfrey, Keith
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Chan, Jerry Kok Yen
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Shek, Lynette P.
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Chong, Yap-Seng
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Tan, K.H.
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Ang, Seng Bin
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Tan, H.H.
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Chern, Bernard SM
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Yap, Fabian
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Lee, Yung Seng
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Lek, Ngee
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Leow, Melvin Khee-Shing
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Khoo, Chin Meng
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Chan, Shiao-Yng
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Chu, Anne H.Y.
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Aris, I.M.
ee15a46e-ead3-4b4a-a208-d39038a85480
Ng, Sharon
cb549f0f-0584-4498-8c49-6023fde1fa87
Bernard, Jonathan Y.
c831fc27-9e1a-46ca-b335-859e14c5083b
Mya, Tint
6f8cd9a6-2667-4495-b1c9-40c7ff3ffb28
Yuan, Wen Lun
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Godfrey, Keith
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Chan, Jerry Kok Yen
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Shek, Lynette P.
9a77403c-0e0c-4536-a5ad-628ce94b279a
Chong, Yap-Seng
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Tan, K.H.
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Ang, Seng Bin
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Tan, H.H.
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Chern, Bernard SM
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Yap, Fabian
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Lee, Yung Seng
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Lek, Ngee
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Leow, Melvin Khee-Shing
b8c72ca5-6a27-4e19-83fe-216fe6f8c536
Khoo, Chin Meng
0c1a537b-4ccd-4971-84ee-14e478f28bea
Chan, Shiao-Yng
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Chu, Anne H.Y., Aris, I.M., Ng, Sharon, Bernard, Jonathan Y., Mya, Tint, Yuan, Wen Lun, Godfrey, Keith, Chan, Jerry Kok Yen, Shek, Lynette P., Chong, Yap-Seng, Tan, K.H., Ang, Seng Bin, Tan, H.H., Chern, Bernard SM, Yap, Fabian, Lee, Yung Seng, Lek, Ngee, Leow, Melvin Khee-Shing, Khoo, Chin Meng and Chan, Shiao-Yng (2020) Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort. Scientific Reports, 10 (1), [9228]. (doi:10.1038/s41598-020-66147-x).

Record type: Article

Abstract

We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiver-operating characteristic (AUROC) curves were used to analyze associations of anthropometric (weight, height, waist/hip circumferences, 4-site skinfold thicknesses) and HbA1c z-scores with dysglycemia (fasting glucose ≥6.1 mmol/L with 2-hour glucose ≥7.8 mmol/l). The prevalence of dysglycemia was 10.9%. After adjusting for sociodemographic/medical history, BMI (Odds Ratio [OR] = 1.62 [95%CI 1.32–1.99]), waist-to-height ratio (OR = 1.74 [1.39–2.17]) and total skinfolds (OR = 2.02 [1.60–2.55]) showed the strongest associations with dysglycemia but none outperformed HbA1c (OR = 4.09 [2.81–5.94]). After adjustment for history, adding BMI, waist-to-height ratio and total skinfolds (anthropometry trio) as continuous variables to HbA1c (AUROC = 0.80 [95%CI 0.75–0.85]) performed similarly to HbA1c alone (AUROC = 0.79 [0.74–0.84]). However, using clinically-defined thresholds without considering history, as in common clinical practice, BMI ≥ 23 kg/m2 + HbA1c ≥ 5.7% (AUROC = 0.70 [0.64–0.75]) and anthropometry trio + HbA1c ≥ 5.7% (AUROC = 0.71 [0.65–0.76]) both outperformed HbA1c ≥ 5.7% alone (AUROC = 0.61 [0.57–0.65]). In a two-stage strategy, incorporating BMI ≥ 23 kg/m2 alongside HbA1c ≥ 5.7% into first-stage screening to identify high risk women for subsequent oral glucose tolerance testing improves dysglycemia detection in Asian women preconception.

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More information

Accepted/In Press date: 12 May 2020
e-pub ahead of print date: 8 June 2020
Published date: 1 December 2020
Additional Information: Funding Information: The S-PRESTO study group includes Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Bee Wah Lee, Bobby Cheon, Christiani Jeyakumar Henry, Ciaran Gerard Forde, Claudia Chi, Doris Fok, Elaine Quah, Elizabeth Tham, Evelyn Chung Ning Law, Evelyn Xiu Ling Loo, Faidon Magkos, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Yu Chen, Hugo P S van Bever, Joanne Yoong, Joao N. Ferreira., Jonathan Tze Liang Choo, Kenneth Kwek, Kuan Jin Lee, Lieng Hsi Ling, Ling Wei Chen, Lourdes Mary Daniel, Marielle V. Fortier, Mary Foong-Fong Chong, Mei Chien Chua, Michael Meaney, Neerja Karnani, Oon Hoe Teoh, Queenie Ling Jun Li, Sendhil Velan, Shephali Tagore, Shirong Cai, Shu E Soh, Sok Bee Lim, Stella Tsotsi, Stephen Chin-Ying Hsu, Sue Anne Toh, Teng Hong Tan, Tong Wei Yew, Victor Samuel Rajadurai, Wee Meng Han, Wei Wei Pang, Yin Bun Cheung, and Yiong Huak Chan. We also acknowledge the efforts of the research coordinators, admin staff, study managers and participants. This work was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore - NMRC/TCR/004-NUS/2008; NMRC/ TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. Funding Information: K.M.G. has received reimbursement for speaking at a Nestle Nutrition Institute conference and is part of an academic consortium that has received research funding from Nestec to examine relations between maternal nutrition and epigenetic and phenotypic outcomes. Y.S.C. reports grants from Abbott Nutrition, Nestec, and Danone outside the submitted work. S.Y.C. is part of an academic consortium that has received research funding from Nestec unrelated to the submitted work. All other authors declare no financial relationships with any organizations that might have an interest in the submitted work in the previous three years and no other relationships or activities that could appear to have influenced the submitted work. Publisher Copyright: © 2020, The Author(s).

Identifiers

Local EPrints ID: 442023
URI: http://eprints.soton.ac.uk/id/eprint/442023
ISSN: 2045-2322
PURE UUID: 8d6483b4-e67c-48d4-80aa-ccf111e7d1d6
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 06 Jul 2020 16:30
Last modified: 28 Oct 2022 04:03

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Contributors

Author: Anne H.Y. Chu
Author: I.M. Aris
Author: Sharon Ng
Author: Jonathan Y. Bernard
Author: Tint Mya
Author: Wen Lun Yuan
Author: Keith Godfrey ORCID iD
Author: Jerry Kok Yen Chan
Author: Lynette P. Shek
Author: Yap-Seng Chong
Author: K.H. Tan
Author: Seng Bin Ang
Author: H.H. Tan
Author: Bernard SM Chern
Author: Fabian Yap
Author: Yung Seng Lee
Author: Ngee Lek
Author: Melvin Khee-Shing Leow
Author: Chin Meng Khoo
Author: Shiao-Yng Chan

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