Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia
Abstract Background The oral glucose-tolerance test (OGTT) is currently the standard method for diagnosis of gestational diabetes (GDM). We conducted a post hoc analysis using the Australian Hyperglycemia and Adverse Pregnancy Outcome (HAPO) data to determine seasonal variations in OGTT results, the...
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doaj-86401967299b4039ab761157aa96987e2020-11-25T03:05:51ZengBMCBMC Pregnancy and Childbirth1471-23932019-07-011911710.1186/s12884-019-2413-5Seasonality, temperature and pregnancy oral glucose tolerance test results in AustraliaEddie X. Shen0Robert G. Moses1Jeremy J.N. Oats2Julia Lowe3H. David McIntyre4Faculty of Medicine, The University of QueenslandIllawarra and Shoalhaven Local Health District, Wollongong HospitalMelbourne School of Global and Population Health, University of MelbourneUniversity of TorontoFaculty of Medicine, The University of QueenslandAbstract Background The oral glucose-tolerance test (OGTT) is currently the standard method for diagnosis of gestational diabetes (GDM). We conducted a post hoc analysis using the Australian Hyperglycemia and Adverse Pregnancy Outcome (HAPO) data to determine seasonal variations in OGTT results, the consequent prevalence of GDM, and association with select perinatal parameters. Method Women enrolled in the Australian HAPO study sites (Brisbane and Newcastle) from 2001 to 2006 were included if OGTT results between 24 to 32 weeks gestation were available (n = 2120). Fasting plasma glucose, 1-h plasma glucose, 2-h plasma glucose, HbA1c, HOMA-IR, and umbilical cord C-peptide and glucose values were categorized by season and correlated to monthly temperature records from the Australian Bureau of Meteorology for Brisbane and Newcastle. GDM was defined post hoc using the IADPSG/WHO criteria. Results Small but significant (p < 0.01 on ANOVA) elevations in fasting glucose (+ 0.12 mM), HbA1c (+ 0.09%), and HOMA-IR (+ 0.88 units) were observed during the winter months. Conversely, higher 1-h (+ 0.19 mM) and 2-h (+ 0.33 mM) post-load glucose values (both p < 0.01) were observed during the summer months. The correlations between fasting glucose, 1-h glucose, 2-h glucose, and HbA1c with average monthly temperatures confirmed this trend, with positive Pearson’s correlations between 1-h and 2-h glucose with increasing average monthly temperatures, and negative correlations with fasting glucose and HbA1c. Further, umbilical cord C-peptide and glucose displayed negative Pearson’s correlation with average monthly temperature, aligned with trends seen in the fasting plasma glucose. Overall prevalence of GDM did not display significant seasonal variations due to the opposing trends seen in the fasting versus 1-h and 2-h post-load values. Conclusion A significant winter increase was observed for fasting plasma glucose, HbA1c, and HOMA-IR, which contrasted with changes in 1-h and 2-h post-load venous plasma glucose values. Interestingly, umbilical cord C-peptide and glucose displayed similar trends to that of the fasting plasma glucose. While overall prevalence of GDM did not vary significantly by seasons, this study illustrates that seasonality is indeed an additional factor when interpreting OGTT results for the diagnosis of GDM and provides new direction for future research into the seasonal adjustment of OGTT results.http://link.springer.com/article/10.1186/s12884-019-2413-5Gestational diabetes mellitusOral glucose tolerance testingSeasonal variabilityHAPOFetal outcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eddie X. Shen Robert G. Moses Jeremy J.N. Oats Julia Lowe H. David McIntyre |
spellingShingle |
Eddie X. Shen Robert G. Moses Jeremy J.N. Oats Julia Lowe H. David McIntyre Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia BMC Pregnancy and Childbirth Gestational diabetes mellitus Oral glucose tolerance testing Seasonal variability HAPO Fetal outcomes |
author_facet |
Eddie X. Shen Robert G. Moses Jeremy J.N. Oats Julia Lowe H. David McIntyre |
author_sort |
Eddie X. Shen |
title |
Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia |
title_short |
Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia |
title_full |
Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia |
title_fullStr |
Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia |
title_full_unstemmed |
Seasonality, temperature and pregnancy oral glucose tolerance test results in Australia |
title_sort |
seasonality, temperature and pregnancy oral glucose tolerance test results in australia |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2019-07-01 |
description |
Abstract Background The oral glucose-tolerance test (OGTT) is currently the standard method for diagnosis of gestational diabetes (GDM). We conducted a post hoc analysis using the Australian Hyperglycemia and Adverse Pregnancy Outcome (HAPO) data to determine seasonal variations in OGTT results, the consequent prevalence of GDM, and association with select perinatal parameters. Method Women enrolled in the Australian HAPO study sites (Brisbane and Newcastle) from 2001 to 2006 were included if OGTT results between 24 to 32 weeks gestation were available (n = 2120). Fasting plasma glucose, 1-h plasma glucose, 2-h plasma glucose, HbA1c, HOMA-IR, and umbilical cord C-peptide and glucose values were categorized by season and correlated to monthly temperature records from the Australian Bureau of Meteorology for Brisbane and Newcastle. GDM was defined post hoc using the IADPSG/WHO criteria. Results Small but significant (p < 0.01 on ANOVA) elevations in fasting glucose (+ 0.12 mM), HbA1c (+ 0.09%), and HOMA-IR (+ 0.88 units) were observed during the winter months. Conversely, higher 1-h (+ 0.19 mM) and 2-h (+ 0.33 mM) post-load glucose values (both p < 0.01) were observed during the summer months. The correlations between fasting glucose, 1-h glucose, 2-h glucose, and HbA1c with average monthly temperatures confirmed this trend, with positive Pearson’s correlations between 1-h and 2-h glucose with increasing average monthly temperatures, and negative correlations with fasting glucose and HbA1c. Further, umbilical cord C-peptide and glucose displayed negative Pearson’s correlation with average monthly temperature, aligned with trends seen in the fasting plasma glucose. Overall prevalence of GDM did not display significant seasonal variations due to the opposing trends seen in the fasting versus 1-h and 2-h post-load values. Conclusion A significant winter increase was observed for fasting plasma glucose, HbA1c, and HOMA-IR, which contrasted with changes in 1-h and 2-h post-load venous plasma glucose values. Interestingly, umbilical cord C-peptide and glucose displayed similar trends to that of the fasting plasma glucose. While overall prevalence of GDM did not vary significantly by seasons, this study illustrates that seasonality is indeed an additional factor when interpreting OGTT results for the diagnosis of GDM and provides new direction for future research into the seasonal adjustment of OGTT results. |
topic |
Gestational diabetes mellitus Oral glucose tolerance testing Seasonal variability HAPO Fetal outcomes |
url |
http://link.springer.com/article/10.1186/s12884-019-2413-5 |
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