Wrist circumference (WrC) in early gestation: A novel anthropometric predictor of gestational diabetes mellitus (GDM) in Asian Indian women.

Abstract

To investigate the association between early gestational Wrist circumference (WrC) and risk of gestational diabetes mellitus (GDM) in Indian pregnant women. In this prospective case-control study, pregnant women of 18-40 years at 6-14 weeks of gestation, were subjected to anthropometric and biochemical evaluations including wrist circumference, waist and hip circumference, waist: hip ratio, fasting plasma glucose, fasting insulin, lipid profiles, HbA1c. Insulin sensitivity was calculated by HOMA IR, QUICKI and McAuley's index. Patients were followed up to 24-28 weeks of gestation with 75 g-OGTT to diagnose GDM. After initial screening of 232 patients, 173 patients were included in the study. Based on the oral glucose tolerance test (OGTT) at 24-28 weeks of gestation, patients were divided into GDM group (<i>n</i> = 32) and NGT (<i>n</i> = 141). Mean WrC in the dominant hand was higher in GDM patients compared to NGT group (15.86 ± 1.99 cm vs. 15.33 ± 2.18, <i>P</i> = 0.006) with similar observations in the non-dominant hand (16.1 ± 2.26 cm vs. 15.6 ± 1.98, <i>P</i> = 0.001). On regression analysis, non-dominant WrC, WHR and WC emerged to be independent predictors for GDM in the entire cohort [OR: 1.86 (1.62-2.06), OR: 1.48 (1.19-1.82) and OR: 1.23 (1.01-1.45) for WrC, WHR and WC respectively, (<i>P</i> _all < 0.001). However, dominant WrC failed to prove an independent predictor of GDM in this cohort (<i>P</i> = 0.112). The non-dominant WrC of >16.1 cm demonstrated 79% sensitivity and 68% specificity to predict onset of GDM (AUC 0.765, 95% CI 0.62-0.89, <i>P</i> = 0.001), which was superior to established measures of WC and WHR. Wrist circumference in non-dominant hand measured at early gestation could potentially predict the onset of GDM in Asian Indian pregnant women.