PW14 - BODY COMPOSITION AS A TOOL FOR METABOLIC SYNDROME DETECTION IN WOMEN SIX YEARS POSTPARTUM

PW14

BODY COMPOSITION AS A TOOL FOR METABOLIC SYNDROME DETECTION IN WOMEN SIX YEARS POSTPARTUM

B. López–Plaza 1,2, L. del Valle Diez 1, A. Larrad-Sáinz2, V. Melero Álvarez3, J. Valerio Deogracia3,4, A. Barabash Bustelo1,2,5, P. Matía-Martín1,2,5,*, A. L. Calle-Pascual1,2,5

1Medicine Department, Universidad Complutense, 2Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria San Carlos (IdISSC), 3Endocrinology and Nutrition Department, Hospital Clínico San Carlos, 4Universidad Alfonso X el Sabio, 5Ciberdem, Madrid, Spain

 

Rationale: Gestational Diabetes Mellitus (GDM) and, gestation itself, can act as a risk factor for developing Metabolic Syndrome (MetS). However, high waist circumference (HWC) does not seem to be a suitable anthropometric MetS criterion years after giving birth. Therefore, the study’s main objective was to evaluate the body composition (BC) as a tool for MetS detection in women six years postpartum (6y–PP).

Methods: A 6y–PP retrospective longitudinal study was carried out in women, without new pregnancy, who developed GDM (or not) during pregnancy. A cohort of 2500 pregnant women were evaluated and monitored by the Nutrition Department (Hospital Clínico San Carlos) from the 12 gestational weeks until 6y–PP. GDM diagnosis was evaluated through IADPSG criteria1 (75 g SOG) and harmonized criteria2 were used for MetS diagnosis at 6y–PP. BC was assessed by electrical bioimpedance (Seca mBCA 515®).

Results: At 6y–PP, BC was evaluated in 604 women (40±5 y old). HWC (>89,5 cm) was not a conditioning factor for 6y–PP MetS development (OR = 1,58 [0,956–2,611]). BC parameters were no different in No GDM vs. GDM, but clearly statistically different between No MetS vs. MetS (Table 1). Among the ROC Models, the Fat Mass (FM) cut-off of 26,5 kg [(AUC = 0,885 [0,854–0,917], Sensitivity (Se, 81%), Specificity (Sp, 80%), PPV (45%), NPV (95%)] or 1,5 L of Visceral Fat [(AUC = 0,859 [0,817–0,901], Se (80%), Sp (78%), PPV (41%), NVP (95%)] were good discriminators for MetS.

Table 1. Anthropometric and body composition parameters six years postpartum (Mean ± SD)

 

 

No GDM (n = 480)

GDM (n = 124)

No MetS (n= 501)

 MetS (n= 103)

 

 

Weight

WC > 89,5 cm

BMI ≥ 25 kg/m2

(kg)

n (%)

n (%)

64,82 ± 11,45

69 (14,4)

213 (44,4)

66,72 ± 12,31

26 (21)

62 (50)

62,38 ± 9,57

19 (3,8)

179 (35,7)

78,91 ± 11,14 †

79 (76,7) †

102 (99,0) †

FM

Visceral fat

FFM

FFMI

FM/FFM

(kg)

(L)

(kg)

(kg/m2)

 

23,39 ± 8,25

1,13 ± 0,67

41,39 ± 4,38

15,92 ± 1,45

0,56 ± 0,17

24,66 ± 8,52

1,25 ± 0,71

42,03 ± 4,79

16,24 ± 1,76

0,58 ± 0,17

21,53 ± 6,66

1,00 ± 0,55

40,92 ± 4,26

15,68 ± 1,31

0,52 ± 0,14

33,97 ± 7,85 †

1,97 ± 0,69 †

44,52 ± 4,32 †

17,52 ± 1,58 †

0,76 ± 0,15 †

SMM

SMMI

SMM/Weight

(kg)

(kg/m2)

 

17,99 ± 2,04

6,83 ± 0,68

0,28 ± 0,04

18,16 ± 2,44

6,96 ± 0,82

0,28 ± 0,04

17,8 ± 2,04

6,74 ± 0,63

0,29 ± 0,04

19,13 ± 2,22 †

7,39 ± 0,82 †

0,24 ± 0,02 †

TBW

ECW

ECW/TBW

(L)

(L)

 

30,81 ± 3,39

13,56 ± 1,53

0,45 ± 0,02

31,22 ± 3,86

13,74 ± 1,67

0,45 ± 0,03

30,41 ± 3,34

13,45 ± 1,5

0,45 ± 0,02

33,31 ± 3,22 †

14,76 ± 1,28 †

0,45 ± 0,02

PhA

Resistance

Reactance

( º )

(ohm)

(ohm)

5,04 ± 0,48

679,54 ± 72,75

59,67 ± 7,08

5,12 ± 0,51

662,87 ± 81,01 *

59,69 ± 7,48

5,0 ± 0,47

687,68 ± 70,16

60,15 ± 7,1

5,29 ± 0,53 †

620,23 ± 71,25 †

57,37 ± 6,99 †

GDM, Gestational Diabetes Mellitus; MetS, Metabolic Syndrome
WC, waist circumference; BMI, Body mass index; FM, Fat Mass; FFM, Fat free mass; FFMI, Fat free mass index,  SMM, Skeletal muscle mass (adjusted by Janssen formula); SMMI, Skeletal muscle mass index; ECW, Extracellular water; TBW, Total body water; PhA, Phase Angle. * p<0,05 Significant differences between No GMD vs. GDM † p<0,001 Significant differences between No MetS vs. MetS

Conclusion: Since HWC was similar regardless of whether women developed MetS 6y–PP, the BC parameters, such as FM and Visceral Fat, seem to be more sensitive indicators. These measures may serve as valuable alternatives for detecting the presence of MetS years after childbirth.

References: 1 National Institutes of Health consensus development conference statement: diagnosing gestational diabetes mellitus, March 4-6, 2013. Obstet Gynecol. 2013 Aug;122(2 Pt 1):358-369. doi: 10.1097/AOG.0b013e31829c3e64. PMID: 23969806.

 

2 Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr; International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640-5. doi: 10.1161/CIRCULATIONAHA.109.192644. Epub 2009 Oct 5. PMID: 19805654.

Disclosure of Interest: None declared