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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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/7417356 |
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| author | Zhirong Miao Honghua Wu Liu Ren Nan Bu Lili Jiang Huixia Yang Junqing Zhang Xiaohui Guo |
| author_facet | Zhirong Miao Honghua Wu Liu Ren Nan Bu Lili Jiang Huixia Yang Junqing Zhang Xiaohui Guo |
| author_sort | Zhirong Miao |
| collection | DOAJ |
| 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<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. |
| format | Article |
| id | doaj-art-3a819e070e4b4c5187ac1f6c826ae1da |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-3a819e070e4b4c5187ac1f6c826ae1da2025-02-03T05:49:52ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/74173567417356Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes MellitusZhirong Miao0Honghua Wu1Liu Ren2Nan Bu3Lili Jiang4Huixia Yang5Junqing Zhang6Xiaohui Guo7Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Gynecology and Obstetrics, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaDepartment of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, ChinaAims. 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<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.http://dx.doi.org/10.1155/2020/7417356 |
| spellingShingle | Zhirong Miao Honghua Wu Liu Ren Nan Bu Lili Jiang Huixia Yang Junqing Zhang Xiaohui Guo Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus International Journal of Endocrinology |
| title | Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus |
| title_full | Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus |
| title_fullStr | Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus |
| title_full_unstemmed | Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus |
| title_short | Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus |
| title_sort | long term postpartum outcomes of insulin resistance and β cell function in women with previous gestational diabetes mellitus |
| url | http://dx.doi.org/10.1155/2020/7417356 |
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