Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus

Aims. The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods. A total of 321 fema...

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Published in:International journal of endocrinology 2020, Vol.2020 (2020), p.1-7
Main Authors: Guo, Xiaohui, Yang, Huixia, Jiang, Lili, Bu, Nan, Ren, Liu, Wu, Honghua, Miao, Zhirong, Zhang, Junqing
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container_title International journal of endocrinology
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Yang, Huixia
Jiang, Lili
Bu, Nan
Ren, Liu
Wu, Honghua
Miao, Zhirong
Zhang, Junqing
description Aims. The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods. A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Results. The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P
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The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods. A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Results. The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P&lt;0.001), while HOMA-β was decreased (1.19 vs. 1.11 vs. 0.71, P=0.011). In pairwise comparison, except for HOMA-IR between prediabetes and T2DM, and HOMA-β between NGT and prediabetes, other differences showed significance. Conclusions. 75 g OGTT 2h PG during pregnancy higher than 9.03 mmol/L is regarded as an independent risk factor of postpartum hyperglycemia. Insulin resistance with insufficient insulin secretion compensation is still common phenomenon during long-term postpartum. Women with heavier insulin resistance in the postpartum period are more likely develop prediabetes, while decreased β-cell function contributes more to T2DM development.</description><identifier>ISSN: 1687-8337</identifier><identifier>EISSN: 1687-8345</identifier><identifier>DOI: 10.1155/2020/7417356</identifier><identifier>PMID: 32184821</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><ispartof>International journal of endocrinology, 2020, Vol.2020 (2020), p.1-7</ispartof><rights>Copyright © 2020 Zhirong Miao et al.</rights><rights>Copyright © 2020 Zhirong Miao et al. 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-3b960a40eefba6c549553b5228b72a62608b1fd8f204d4dff833d4297fac37223</citedby><cites>FETCH-LOGICAL-c509t-3b960a40eefba6c549553b5228b72a62608b1fd8f204d4dff833d4297fac37223</cites><orcidid>0000-0002-9095-2202 ; 0000-0002-5841-9248 ; 0000-0002-5588-0995 ; 0000-0002-8574-1945</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061142/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061142/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32184821$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Francomano, Davide</contributor><creatorcontrib>Guo, Xiaohui</creatorcontrib><creatorcontrib>Yang, Huixia</creatorcontrib><creatorcontrib>Jiang, Lili</creatorcontrib><creatorcontrib>Bu, Nan</creatorcontrib><creatorcontrib>Ren, Liu</creatorcontrib><creatorcontrib>Wu, Honghua</creatorcontrib><creatorcontrib>Miao, Zhirong</creatorcontrib><creatorcontrib>Zhang, Junqing</creatorcontrib><title>Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus</title><title>International journal of endocrinology</title><addtitle>Int J Endocrinol</addtitle><description>Aims. The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods. A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Results. The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P&lt;0.001), while HOMA-β was decreased (1.19 vs. 1.11 vs. 0.71, P=0.011). In pairwise comparison, except for HOMA-IR between prediabetes and T2DM, and HOMA-β between NGT and prediabetes, other differences showed significance. Conclusions. 75 g OGTT 2h PG during pregnancy higher than 9.03 mmol/L is regarded as an independent risk factor of postpartum hyperglycemia. Insulin resistance with insufficient insulin secretion compensation is still common phenomenon during long-term postpartum. 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The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods. A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Results. The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P&lt;0.001), while HOMA-β was decreased (1.19 vs. 1.11 vs. 0.71, P=0.011). In pairwise comparison, except for HOMA-IR between prediabetes and T2DM, and HOMA-β between NGT and prediabetes, other differences showed significance. Conclusions. 75 g OGTT 2h PG during pregnancy higher than 9.03 mmol/L is regarded as an independent risk factor of postpartum hyperglycemia. Insulin resistance with insufficient insulin secretion compensation is still common phenomenon during long-term postpartum. 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title Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus
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