Association of Obesity Indicators with Gestational Diabetes: A Comparative Study from NHANES

This study aims to explore the relationships between various obesity-related indicators and gestational diabetes mellitus (GDM), as well as assess their ability to predict GDM development.

Data from the 2007-2020 National Health and Nutrition Examination Survey included 4,000 women with either a history of live birth or a gestational age of at least 28 weeks. We used weighted multivariable logistic regression to examine the links between nine obesity indicators-such as body roundness index (BRI), relative fat mass (RFM), lipid accumulation product (LAP), visceral adiposity index (VAI), waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), Conicity Index, body shape index (ABSI), and body mass index (BMI)-and GDM. To explore potential nonlinear relationships, restricted cubic splines were employed, and receiver operating characteristic (ROC) curves were used to evaluate and compare the predictive accuracy of each measure.

Among participants, 352 individuals (8.8%) were diagnosed with GDM. There were positive correlations between GDM risk and RFM, BRI, VAI, LAP, WHtR, WWI, Conicity Index, and BMI, while ABSI showed no significant correlation. Nonlinear analysis indicated threshold effects for VAI, LAP, and BMI concerning GDM.

RFM demonstrated the strongest predictive ability with the highest area under the curve (0.690; 95% CI: 0.662-0.717). Subgroup analysis revealed an interaction between alcohol consumption and the relationship between RFM and GDM (P = 0.039).

RFM showed the most consistent association with GDM and achieved the best predictive performance, making it a promising candidate for clinical screening of women at high risk for GDM.