Zahra Kashi, Shiva Borzouei, Ozra Akhi, Narges Moslemi Zadeh, Hamidreza Zakeri, Reza Mohammadpour Tahmtan, Rafat Bonafti, Leila Shahbazadeh,
Volume 6, Issue 1 (19 2006)
Abstract
Background: Detecting mothers with gestational diabetes mellitus (GDM) is not only important in prevention of prenatal morbidities but also has significant effect on neonatal and maternal long term outcomes. Today, there are screening tests for GDM but they are time-consuming and expensive, therefore it seems necessary to perform testes that are uses expensive but with higher sensitivity and specificity. The aim of this study was to determine a cut - off point of fasting plasma glucose (FPG) for screening of GDM.
Methods: 200 pregnant women referring to the perinatal clinic of Imam Khomeini hospital, (Sari – Iran) were studied. All cases with age ≥25 years old, history of recurrent abortion, GDM, preeclampsia, macrosomia, still birth, diabetes mellitus(DM) in first degree family or pre gestational body mass index ≥25kg/m2 were selected. Those with pre gestational diabetes mellitus were excluded. All of participants underwent a 50 g glucose challenge test (GCT) between the 24th and 28th gestational week. If 1- hour plasma glucose was more than 130 mg/dl, a 3- hour 100g oral glucose tolerance test (OGTT) was performed. The diagnosis of GDM was made by ADA 2006 recommendation (Carpenter and Coustan diagnostic criteria). Referring to the Receiver Operative Characteristic Curve, level of FPG having highest sensitivity and specificity in diagnosis of GDM was determined.
Results: From 200 participants, 65 women had positive GCT, of them 58 (response rate 89%) referred for 100g OGTT and 20(10%) were diagnosed GDM. Using ROC curve and under curve area of 0.853 the FBG level of 91.5 mg/dl, showed the highest sensitivity and specificity, 80% and 92% respectively in diagnosis of GDM.
Conclusion: FBG ≥ 91.5 mg/dl has good sensitivity and specificity in screening of GDM. Since this is simpler and cheaper than 50g GCT, is recommended as a screening method in diagnosis of GDM.
Zahra Hajhashemy, Elham Moslemi, Parvane Saneei,
Volume 21, Issue 2 (7-2021)
Abstract
Background: Although the relation of serum vitamin D levels with abdominal obesity has been investigated by previous observational studies, the results are inconsistent. In the current study, a dose-response meta-analysis was conducted on epidemiologic studies that evaluated this association in adults.
Methods: We performed a systematic search of all published articles, up to May 2020, in five electronic databases. A total of 41 observational studies that reported odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs) for abdominal obesity in relation to serum vitamin D levels in adults were found.
Results: Meta-analysis on 36 cross-sectional studies (combining 44 effect sizes) with 257699 participants, illustrated that the highest serum vitamin D level in comparison with the lowest serum vitamin D level was significantly related to 23% decreased odds of central obesity (OR=0.77; 95%CI:0.71-0.83). This inverse association was also significant in almost all subgroups based on different covariates. Based on dose-response analysis, each 25 nmol/l increase in serum vitamin D levels, was related to 8% reduced risk of central obesity (OR=0.92;95%CI:0.85,0.99). After limiting the analysis to 23 effect sizes from 17 studies with representative population (242135 participants), the same results were obtained (OR=0.79; 95%CI: 0.71-0.87). Based on dose-response analysis on studies with representative populations, each 25 nmol/l increase in blood vitamin D levels was linked to 10% decreased central adiposity risk(OR=0.90; 95%CI: 0.82, 0.99).
Conclusion: In this meta-analysis of epidemiologic studies, we demonstrated an inverse significant relation between serum vitamin D levels and risk of central obesity in adults, in a dose-response manner. The same findings were obtained in representative populations.
