Insulin Resistance in Gestational Diabetes Mellitus and Its Association With Anthropometric Fetal Indices

BACKGROUND: In pregnant women with gestational diabetes mellitus (GDM). insulin resistance (IR) increases the risk of developing manifest type 2 diabetes mellitus and is associated with complications in both mother and fetus. OBJECTIVES: This research aimed to evaluate the associations between IR evaluated by 3 indices (namely updated homeostasis model assessment model (HOMA2). QUICKI, and McAuley's index) and the diabetes risk factors and the fetal growth indices in Vietnamese women with GDM. METHODS: A cross-sectional descriptive study was conducted on 370 women with GDM and 40 healthy pregnant women from January 2015 to May 2019. IR was calculated by HOMA2 (HOMA2-IR), QUICKI, and McAuley's index. Fetal anthropometric measurements were assessed via ultrasound which was performed and interpreted by ultrasound experts. RESULTS: In the simple regression analysis, McAuley's index illustrated had statistically significant correlations to the highest number of risk factors of diabetes mellitus compared with HOMA2-IR and QUICKI indices. Moreover, McAuley's index correlated statistically significantly to the highest number of fetal ultrasound measurements factors such as including biparietal diameter (BPD) (r= -0.271, P< .001), head circumference (HC) (r= -0.225, P<.001), abdominal circumference (AC) (r= -0.214, P<.001), femur length (FL) (r= -0.231, P< .001). estimated fetal weight (EFW) (r= -0.239, P<,001) and fetal estimated age (r= -0.299, P<.001). In the multivariable analysis, the McAuley's index contributed the greatest to AC (Standardized B of -0.656. P< .001). CONCLUSION: The McAuley's index was significantly associated with a higher number of more risk factors for diabetes mellitus as well as fetal ultrasound sonography findings measurements than compared with HOMA2-IR and QUICKI indices.