Evidence map›Paper›PMID 40830961›Full record

ArticleBMC medicine2025

Dynamic OGTT-derived C-peptide trajectories for metabolic heterogeneity and adverse pregnancy outcomes in gestational diabetes mellitus: a nested case‒control study.

Xinyue Wang, Zhangya He, Jing Ji, Simin Zhang, Jinglin Li, Jiahui Zhang, Wenlu Yu, Hexiang Yang, Zhen Han, Yang Mi and 1 more

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In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Xinyue Wang *Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Zhangya He *Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Jing JiDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Simin ZhangDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Jinglin LiDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Jiahui ZhangDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Wenlu YuDepartment of Maternal and Child Health, Xianyang Maternal and Child Health Hospital, Xianyang, 712000, China.
Hexiang YangDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
Zhen HanDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Yang MiDepartment of Obstetrics and Gynecology, Northwest Women and Children's Hospital, Xi'an, 710061, China.
Xiaoqin LuoDepartment of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China. luoxiaoqin2012@mail.xjtu.edu.cn.

Funding

Key Special Project of the Development Center for Medical Science & Technology of the National Health Commission of the People's Republic of China W2015CAE060National Natural Science Foundation of China 81874263Social development in key industry innovation chains 2021ZDLSF02-14
6 · The paper itself

Abstract

backgroundExisting diagnostic criteria for gestational diabetes mellitus (GDM) rely solely on glucose thresholds, which are insufficient to capture metabolic heterogeneity. We aimed to evaluate the role of C-peptide measured during the oral glucose tolerance test (OGTT) in assisting the development of stratified treatment strategies and predicting the risk of adverse pregnancy outcomes.

methodsThis nested case-control study conducted within the Xi'an Longitudinal Mother-Child Cohort included 1014 pregnant women with GDM and 1014 without GDM (non-GDM) who delivered singleton live-born infants between January 1, 2017, and December 31, 2018. C-peptide levels were measured at three intervals during the OGTT. Latent class trajectory modeling was used to identify distinct C-peptide trajectories, and logistic regression was used to assess their associations with adverse fetal and maternal outcomes.

resultsTwo principal C-peptide trajectories were identified in GDM despite similar glucose profiles. GDM Class 1 (771, 76.04%) presented a delayed 120-min C-peptide peak and poorer beta-cell secretion, whereas GDM Class 2 (243, 23.96%) presented a sharp 60-min peak followed by a decline and significantly increased insulin resistance, with greater risks of delivering large for gestational age (LGA) (adjusted odds ratio (aOR), 1.52; 95% confidence interval (CI), 1.07-2.15) and macrosomia (aOR, 1.83; 95% CI, 1.13-2.97). Surprisingly, 21.7% (220) of the non-GDM group had a high C-peptide response associated with elevated preeclampsia risk (aOR, 2.91; 95% CI, 1.25-6.74).

conclusionsDynamic OGTT-derived C-peptide trajectories revealed clinically significant metabolic subgroups of GDM that were obscured by glucose-only diagnostics, with the predominantly insulin-resistant Class being at higher risk of fetal overgrowth.

Indexed as

C-PeptideDiabetes, GestationalPregnancy OutcomeAdultBlood GlucoseCase-Control StudiesFemaleGlucose Tolerance TestHumansInsulin ResistanceLongitudinal StudiesPregnancyBlood GlucoseC-PeptideBeta-cell functionC-peptideGestational diabetes mellitusInsulin resistanceLatent class trajectory analysis

Identifiers

PMID40830961
PMCPMC12366374

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.