Insulin secretory defect may be the major determinant of GDM in lean mothers

Sharmin-Jahan,; Mashfiqul-Hasan,; Nusrat-Sultana,; Mohona-Zaman, None; Rakibul-Hasan, M.; Fariduddin, M; Hasanat, Muhammad Abul

doi:10.1016/j.jcte.2020.100226

Cited by 20 publications

(24 citation statements)

References 21 publications

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“…Insulin resistance is shown to be increased during pregnancy as demonstrated by increased value of HOMA-IR from 12 weeks to 24 weeks of gestation in the GDM subjects, and significant difference was observed in the HOMA-IR values between GDM group and healthy pregnant women both at 12 and 24 weeks of gestation. Most of the studies have reported higher insulin resistance in GDM subjects when compared to healthy pregnant women in the third trimester of pregnancy, without finding any change in the first trimester [23]. We have not observed any difference in IR among the healthy pregnant women from first to third trimester.…”

Section: Discussioncontrasting

confidence: 69%

Maternal circulating levels of Adipocytokines and insulin resistance as predictors of gestational diabetes mellitus: preliminary findings of a longitudinal descriptive study

Ramachandrayya

D’Cunha

Rebeiro

2020

J Diabetes Metab Disord

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Purpose The present study aimed to assess the role of adipocytokines as predictive markers of gestational diabetes mellitus (GDM). We undertook this study to explore the association of adiponectin, resistin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) and insulin resistance in the development of GDM. Methods This longitudinal descriptive study was done in the Medical College Hospital, involving the departments of Biochemistry and Gynecology. The study subjects were pregnant women with normal body mass index. They were recruited at 12-14 weeks of gestation, The healthy pregnant women were selected and were followed at 24-28 weeks for screening of GDM. The participants were categorized as healthy and GDM based on oral glucose tolerance test results. Blood samples were collected on both the occasions at 12-14 weeks and 24-28 weeks. The serum samples were analyzed for levels of insulin, adiponectin, resistin, IL-6 and TNF-alpha. Insulin resistance (HOMA-IR) was calculated from serum insulin and plasma glucose values. ResultsThe levels of HOMA-IR, resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was significantly lower in GDM subjects in comparison to healthy pregnant women, when compared both at 12 weeks and 24 weeks. The levels of resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was lower at 24 weeks in comparison to 12 weeks, in the healthy pregnant women as well as those with GDM . Conclusions Significant difference in the levels of adipocytokines between the healthy and GDM pregnant women suggest potential clinical application of these molecules as biomarkers of GDM. The increase or decrease in the levels of adipocytokines during the course of pregnancy in GDM subjects suggests their role in GDM and potential use as predictive markers.

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Section: Discussioncontrasting

confidence: 69%

Maternal circulating levels of Adipocytokines and insulin resistance as predictors of gestational diabetes mellitus: preliminary findings of a longitudinal descriptive study

Ramachandrayya

D’Cunha

Rebeiro

2020

J Diabetes Metab Disord

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“…IR and impaired β-cell function are the central pathogenic mechanisms for developing GDM [1]. Higher IR in GDM was also reflected in a recent work of our GDM study group, BSMMU [17]β-cell function (HOMA-B. Nevertheless, insulin secretory capacity measured by HOMA-B in this study was much lower than the findings of other authors [18].…”

Section: Discussionsupporting

confidence: 66%

Body mass index correlates positively with insulin resistance and secretion but inversely with insulin sensitivity in gestational diabetes

Tofail

Jahan

Hasan

et al. 2021

Clinical Diabetology

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Aim. to assess fasting c-peptide and insulin indices using homeostatic model assessment (HOMA) in gestational diabetes mellitus (GDM). Methods. Gestational diabetes mellitus (n = 64, age: 27.02 ± 0.53 years, BMI: 26.3 ± 0.5 kg/m 2 ; mean ± sEM) and normal glucose tolerance NGt (n = 56, age: 26.11 ± 0.55 years, BMI: 24.4 ± 0.4 kg/m 2 ; mean ± sEM) screened according to WHO 2013 criteria. Glucose was measured by oxidase method whereas fasting insulin and c-peptide by ELIsA. HOMA-Ir, HOMA-B and HOMA-%s were calculated. results. c-peptide was found higher in GDM compared to NGT without any significant difference (p = 0.465). Fasting insulin (p = 0.063) and HOMA-Ir (p < 0.001) were significantly higher while HOMA-B (p = 0.015) and HOMA-%S (p = 0.012) were significantly lower in GDM than those of NGt. BMI, bad obstetric history, multiparity and blood glucose were higher (p ≤ 0.05) in GDM while age, duration of gestation, family history of DM did not differ (p = Ns). c-peptide (0.185 ± 0.06 vs 0.331 ± 0.44; p < 0.05), fasting insulin (4.88 ± 0.74 vs 10.37 ± 0.74; p < 0.01) and HOMA-Ir (1.04 ± 0.14 vs 2.48 ± 0.18; p < 0.011) as well as HOMA-B were found lower in GDM having BMI < 23 kg/m 2 than those of GDM with BMI ≥ 23. conversely, HOMA-%s (115.52 ± 14.63 vs 50.62 ± 3.39; p < 0.011) was higher in the subgroup with BMI < 23 than the rest. Fasting blood glucose (FBG) (p < 0.01) and fasting insulin (p < 0.05) were independent predictors for GDM. conclusions. Fasting c-peptide do not differ between GDM and NGt. BMI was positively related with resistance and secretion of insulin but inversely with sensitivity. HOMA model analyses revealed decreased insulin sensitivity and secretory capacity in GDM than NGt. (clin Diabetol 2021; 10

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“…As studies have found that FGF21 can improve tissue insulin sensitivity, promote the proliferation of pancreatic bcells, and increase insulin secretion (15,22,23,25), we suspected that there was a compensatory effect of FGF21 in pregnant women before GDM was identified (25). In addition, studies found that there were some differences in pathogenesis between obese and nonobese GDM women (2,33,40), and in our study, the FGF21 levels of the obese GDM subgroup were significantly higher than those of normal BMI GDM subgroup, which suggested that the mechanism of FGF21 resistance might be different in GDM women with different BMIs. Therefore, interventions that influence FGF21 levels based on different BMIs should be focused on for future research to prevent subsequent GDM.…”

Section: Discussionmentioning

confidence: 98%

FGF21 Serum Levels in the Early Second Trimester Are Positively Correlated With the Risk of Subsequent Gestational Diabetes Mellitus: A Propensity-Matched Nested Case-Control Study

Wang

Yuan

et al. 2021

Front. Endocrinol.

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BackgroundAs an important endocrine hormone regulating glucose metabolism, fibroblast growth factor 21 (FGF21) is increased in individuals with gestational diabetes mellitus (GDM) after 24 gestational weeks. However, it is unknown whether the increase in FGF21 precedes the diagnosis of GDM.MethodsIn this nested case-control study, 133 pregnant women with GDM and 133 pregnant women with normal glucose tolerance (NGT) were identified through propensity score matching, and serum FGF21 levels were measured at 14 to 21 gestational weeks, before GDM is routinely identified. The differences in FGF21 levels were compared. The association between FGF21 and the occurrence of GDM was evaluated using logistic regression models with adjustment for confounders.ResultsThe serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall (P < 0.001), with similar results observed between the corresponding BMI subgroups (P < 0.05). The 2nd (OR 1.224, 95% CI 0.603–2.485), 3rd (OR 2.478, 1.229–5.000), and 4th (OR 3.419, 95% CI 1.626–7.188) FGF21 quartiles were associated with greater odds of GDM occurrence than the 1st quartile after multivariable adjustments.ConclusionsThe serum FGF21 levels in GDM groups increased in the early second trimester, regardless of whether participants were stratified according to BMI. After adjusting for confounding factors, the FGF21 levels in the highest quartile were associated with more than three times higher probability of the diagnosis of GDM in the pregnancy as compared to levels in the first quartile.

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Insulin secretory defect may be the major determinant of GDM in lean mothers

Cited by 20 publications

References 21 publications

Maternal circulating levels of Adipocytokines and insulin resistance as predictors of gestational diabetes mellitus: preliminary findings of a longitudinal descriptive study

Maternal circulating levels of Adipocytokines and insulin resistance as predictors of gestational diabetes mellitus: preliminary findings of a longitudinal descriptive study

Body mass index correlates positively with insulin resistance and secretion but inversely with insulin sensitivity in gestational diabetes

FGF21 Serum Levels in the Early Second Trimester Are Positively Correlated With the Risk of Subsequent Gestational Diabetes Mellitus: A Propensity-Matched Nested Case-Control Study

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