{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:16:15Z","timestamp":1767341775033,"version":"3.48.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate an early second\u2010trimester predictive model integrating body mass index (BMI) trajectories and pathophysiological biomarkers for gestational diabetes mellitus (GDM) risk stratification, with the aim of reducing weight\u2010monitoring frequency while maintaining predictive accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective dual\u2010center cohort study, 1,450 pregnant women (&lt;12\u2009weeks gestation) without preexisting diabetes were enrolled from two Beijing maternal\u2010child hospitals. Serial anthropometric (BMI at 6\u201310, 12\u201314, 15\u201319, and 24\u201328\u2009weeks) and metabolic biomarkers (fasting glucose, C\u2010peptide, lipids, uric acid) were analyzed. GDM was diagnosed via 75\u2009g OGTT at 24\u201328\u2009weeks. Multivariable logistic regression identified predictors using a 7:3 training\u2010test split. Model performance was assessed by area under the ROC curve (AUC), calibration, and decision curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GDM incidence was 26.1% (378\/1,450). Significant weight\/BMI disparities emerged as early as 6\u201310\u2009weeks (GDM vs NGT: +2.3\u2009kg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), escalating through gestation. The final model incorporated age (OR\u2009=\u20091.07\/year, 95% CI\u2009=\u20091.03\u20131.11), 12\u201314\u2010week BMI (OR\u2009=\u20091.06\/kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 1.01\u20131.12), fasting glucose (OR\u2009=\u20091.86\/mmol\/L, 1.45\u20132.40), fasting C\u2010peptide (OR\u2009=\u20091.87\/ng\/mL, 1.28\u20132.73). The model demonstrated moderate discrimination (training AUC\u2009=\u20090.684; testing AUC\u2009=\u20090.685) with 63.7\u201367.2% sensitivity and 59.8\u201361.4% specificity at the optimal threshold (0.237). Negative predictive values exceeded 82%, enabling effective risk exclusion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This dual\u2010center model pioneers GDM risk stratification by 12\u201314\u2009weeks using clinically accessible metrics, reducing weight\u2010monitoring frequency without compromising prognostic value. While AUC limitations (0.68\u20130.69) suggest unmeasured contributors, its operational simplicity and robust negative predictive capacity support implementation in resource\u2010constrained settings. The findings redefine antenatal care paradigms by shifting focus to early metabolic dysregulation rather than late diagnostic thresholds.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70179","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:20:32Z","timestamp":1763018432000},"page":"150-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual\u2010center prospective validation of an early second\u2010trimester predictive model integrating\n                    <scp>BMI<\/scp>\n                    trajectories and pathophysiological biomarkers for gestational diabetes risk stratification"],"prefix":"10.1111","volume":"17","author":[{"given":"Junxiang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuoning","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbei","family":"Duo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Beijing Chaoyang District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuemei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Haidian District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyu","family":"Xu","sequence":"additional","affiliation":[{"name":"Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Haidian District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaorui","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Beijing Chaoyang District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiujin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Beijing Chaoyang District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianchun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Beijing Chaoyang District Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ailing","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Women and Children's Health Chinese Center for Disease Control and Prevention  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengmeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingyue","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zechun","family":"Lu","sequence":"additional","affiliation":[{"name":"National Center for Women and Children's Health Chinese Center for Disease Control and Prevention  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weigang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00825-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002501"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41522-025-00650-9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12854"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1475212"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq195"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12455"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12489"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2017.277"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1478907"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.24241"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.825336"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30217-0"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.41.1.10920"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17040736"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-87135-9"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075226"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-51879-x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05832-x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1723779"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-02936-5"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22158087"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1074\/mcp.RA117.000121"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms252111666"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-024-01278-8"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-023-03544-y"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-021-00698-6"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19102926"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-019-1169-2"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2024.2438714"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12887"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.25606"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280220912772"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.51799"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.05.066"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-016-0768-9"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-024-03306-6"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15234995"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20042908"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07442-1"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-06113-3"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/mas.21777"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.70179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:13:44Z","timestamp":1767341624000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.70179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/jdi.70179"],"URL":"https:\/\/doi.org\/10.1111\/jdi.70179","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"type":"print","value":"2040-1116"},{"type":"electronic","value":"2040-1124"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"2025-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}