Being too thin at 20 linked to gestational diabetes risk

By Sally Robertson, B.Sc.Jun 1 2012

Having a low body mass index (BMI) at the age of 20 years may be a risk factor for developing gestational diabetes, report Japanese researchers.

Furthermore, the risk seems to remain even if women have reached a normal BMI by the time they are in the early stages of pregnancy, say Hirohito Sone (University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan) and team.

"East Asian young women, especially Japanese, strongly desire to be thin despite having a lower BMI than in many other ethnic groups," say the researchers. "This has become a major health issue among East Asian women of childbearing age."

As reported in Diabetic Medicine, the team investigated the association between risk for gestational diabetes and BMI at age 20 years as well as change in BMI since then, in 624 women with a mean gestation of 8.0 weeks at their first antenatal visit.

The women, aged a mean of 33.4 years, self-reported what they weighed at age 20 years and had their current height and weight measured.

The researchers report that 28 (4.5%) women developed gestational diabetes at 24-29 weeks' gestation, defined as a glucose challenge test of 7.8 mmol/L or more.

There was a significant inverse association between BMI at age 20 years and the incidence of gestational diabetes.

Compared with women who had a BMI of at least 18 kg/m² at age 20 years, women with a BMI of less than 18 kg/m² had a 4.9-fold higher risk for developing the condition.

Women whose BMI increased the most since age 20 years, by 1.85 kg/m² or more, had a 2.4-fold greater risk for gestational diabetes than those whose BMI increased by less than this.

However, women who had a BMI of less than 18 kg/m² at 20 years of age still had a 6.3-fold greater risk than both the women with a higher BMI at age 20 years and those with a baseline change in BMI of up to 1.84 BMI units since age 20 years.

"Our results suggest that physiological conditions caused by nutritional deficiencies in early adulthood have later metabolic implications, which may eventually manifest as gestational diabetes," warns the team.

"A large, prospective multi-center study is needed to better evaluate the association of underweight in early adulthood and gestational diabetes."

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