Association of CHG-BMI with gestational diabetes mellitus in two East Asian pregnancy cohorts

Background The cholesterol, high-density lipoprotein, and glucose-body mass index (CHG-BMI) is a novel composite metabolic indicator integrating glucose, lipid, and anthropometric information. Evidence regarding the association between CHG-BMI and gestational diabetes mellitus (GDM) remains limited. Methods A secondary analysis was performed using two independent East Asian pregnancy cohorts, including a Chinese retrospective case-control study (n of 1,277; 567 GDM and 710 non-GDM) and a Korean prospective cohort (n of 583; 36 GDM and 547 non-GDM). In the Korean cohort, biochemical measurements were obtained at 10–14 gestational weeks, whereas the exact sampling week was not available in the public Chinese dataset. The relationship of CHG-BMI with GDM was analyzed using multivariable logistic regression, while restricted cubic spline analysis was used to examine the dose-response pattern. Receiver operating characteristic curves were used to evaluate discriminatory performance. Net reclassification improvement and integrated discrimination improvement were further calculated to assess the incremental value of CHG-BMI beyond the baseline clinical model. Results In both cohorts, CHG-BMI was elevated in the GDM group compared with the non-GDM group. After full adjustment, higher CHG-BMI remained significantly related to GDM in both the Chinese cohort (per-unit OR of 1.03, 95% CI from 1.02 to 1.04; per-SD OR of 1.74, 95% CI from 1.52 to 2.00) and the Korean cohort (per-unit OR of 1.05, 95% CI from 1.03 to 1.07; per-SD OR of 2.34, 95% CI from 1.66 to 3.30). Restricted cubic spline analyses suggested a predominantly linear association in both cohorts. CHG-BMI showed numerically higher discriminatory performance than CHG, pre-pregnancy BMI, total cholesterol, and HDL-C, and provided incremental information beyond the baseline clinical model for risk stratification. Conclusions In two independent East Asian pregnancy cohorts, elevated CHG-BMI was significantly related to GDM. CHG-BMI may serve as an adjunctive composite indicator for GDM risk assessment, with the Korean cohort providing clearer evidence for its potential use in early pregnancy.