Associations of body composition and physical fitness with gestational diabetes and cardiovascular health in pregnancy: Results from the HealthyMoms trial Henriksson, Pontus Ortega Porcel, Francisco Bartolomé Open access funding provided by Linkoping University We gratefully thank the participating women in the HealthyMoms trial. The authors also acknowledge Eva Flinke and Ellinor Nilsson for invaluable help with the data collection and the midwifes in Region Östergötland for help with the recruitment. The HealthyMoms trial is funded by the Swedish Research Council (2016-01147 to M.L.) and additionally supported by the Swedish Research Council for Health, Working Life and Welfare (Forte, 2017-00088 to P.H.; 2018-01410 to M.L.); Bo and Vera Ax:son Johnsons’ Foundation (to M.L.); the Strategic Research Area Health Care Science, Karolinska Institutet/Umeå University (to P.H.); the Swedish Society of Medicine (to P.H.); Karolinska Institutet (to P.H. and M.L.); and Lions Forskningsfond (to P.H.). M.H.L. was supported by a grant from Yrjö Jahnsson Foundation. The aim of this study was to examine associations of body composition (fat mass index, % fat mass, fat-free mass index, body mass index) and physical fitness (cardiorespiratory fitness and handgrip strength) with gestational diabetes and cardiovascular health in early pregnancy. This cross-sectional study utilized baseline data (n = 303) collected in early pregnancy from the HealthyMoms trial. Body composition was measured using air-displacement plethysmography, cardiorespiratory fitness was assessed by means of the 6-min walk test and handgrip strength using a dynamometer. Logistic regression was used to estimate odds ratios (ORs) for gestational diabetes as well as high (defined as 1 SD above the mean) blood pressure, homeostatic model assessment for insulin resistance (HOMA-IR), and metabolic syndrome score (MetS score) per 1 SD increase in body composition and fitness variables. Fat mass index, % fat mass and body mass index were all strongly associated with gestational diabetes (ORs: 1.72-2.14, P <= 0.003), HOMA-IR (ORs: 3.01-3.80, P < 0.001), blood pressure (ORs: 1.81-2.05, P < 0.001) and MetS score (ORs: 3.29-3.71, P < 0.001). Associations with fat-free mass index were considerably weaker (ORs: 1.26-1.82, P = 0.001-0.15) and were strongly attenuated after adjustments for fat mass index (ORs: 0.88-1.54, P = 0.039-0.68). Finally, greater cardiorespiratory fitness was associated with lower risk of high HOMA-IR and MetS score (ORs: 0.57-0.63, P <= 0.004) although these associations were attenuated when accounting for fat mass index (ORs: 1.08-1.11, P >= 0.61). In conclusion, accurately measured fat mass index or % fat mass were strongly associated with gestational diabetes risk and markers of cardiovascular health although associations were not stronger than the corresponding ones for body mass index. Fat-free mass index had only weak associations with gestational diabetes and cardiovascular health which support that the focus during clinical care would be on excess fat mass and not fat-free mass. 2021-07-02T11:40:38Z 2021-07-02T11:40:38Z 2021-06-07 info:eu-repo/semantics/article Henriksson, P... [et al.]. Associations of body composition and physical fitness with gestational diabetes and cardiovascular health in pregnancy: Results from the HealthyMoms trial. Nutr. Diabetes 11, 16 (2021). [https://doi.org/10.1038/s41387-021-00158-z] http://hdl.handle.net/10481/69479 10.1038/s41387-021-00158-z eng http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess Atribución 3.0 España Nature