The Role of METS-IR in Early Screening for Gestational Diabetes Mellitus in Chinese Women: A Two-Center Prospective Study

作者：Junxiang Gao, Shuoning Song, Yanbei Duo, Shihan Wang, Xiaolin Qiao, Yuemei Zhang, Jiyu Xu, Jing Zhang, Xiaorui Nie, Qiujin Sun, Xianchun Yang, Ailing Wang, Wei Sun, Yong Fu, Mengmeng Zhang, Yingyue Dong, Zechun Lu, Tao Yuan, Weigang Zhao · 发表于：Diabetes Metabolic Syndrome and Obesity · 年份：2025 · DOI：10.2147/dmso.s538992 · 被引用次数：5 · 研究领域：Gestational Diabetes Research and Management、Pregnancy and preeclampsia studies、Birth, Development, and Health

Objective: This two-center prospective cohort study aimed to evaluate the predictive value of the Metabolic Score for Insulin Resistance (METS-IR) for gestational diabetes mellitus (GDM) in Chinese women during early pregnancy and compare its performance with conventional insulin resistance (IR) indices. Methods: This prospective investigation evaluated 1450 Chinese gravidas (<12 gestational weeks) without pregestational diabetes from two obstetrical institutions. Baseline clinical-biochemical profiling occurred during the first trimester (6-12 weeks), with GDM confirmation via standardized 75g oral glucose tolerance testing at 24-28 weeks' gestation. Analytical methodologies incorporated multivariable regression modeling and ROC curve optimization to quantify the predictive validity of five metabolic indices (METS-IR, TyG index, TG/HDL-C ratio, HOMA-IR, TyG-BMI) for GDM risk stratification. Results: Among participants, 378 (26.1%) developed GDM. The GDM group (n=378, 26.1%) was older (median age 31.0 vs 30.0 years, p<0.0001) and had higher prepregnancy BMI (22.62 vs 21.32 kg/m², p<0.0001), fasting glucose (4.7 vs 4.5 mmol/L, p<0.0001) compared to NGT. The GDM group exhibited significantly higher METS-IR (31.14 vs 29.03, p <0.001) and other IR indices (p <0.001). In unadjusted models, METS-IR quartile 4 (Q4) was strongly associated with GDM (OR=3.33, 95% CI:2.38-4.70), but this association attenuated after adjusting for age, weight gain, lipids, and insulin (adjusted OR=1.56,...