β-cell dysfunction in women with previous gestational diabetes is associated with visceral adipose tissue distribution

Abstract

Context: Glucose intolerance in pregnancy predicts an increased risk of future type 2 diabetes. Objective: The aim of the study was to evaluate glucose metabolism in women with and without gestational diabetes mellitus (GDM) at 5 years follow-up and identify risk factors associated with disturbed glucose metabolism post-partum. Design: This follow-up study included 300 consecutively enrolled women from a previous population-based cohort study. The participants underwent oral glucose tolerance test under pregnancy and in the follow-up study, in addition to dual-energy X-ray absorptiometry in the follow-up study. Results: Fifty-two women (17.7%) were found to have GDM in pregnancy with an odds ratio of 4.8 developing prediabetes 5 years later. b-cell function, but not insulin resistance or sensitivity, was reduced in the follow-up study after adjusting for known risk factors. Furthermore, visceral fat content at follow-up was increased in GDM women compared to non-GDM women, and the b-cell function declined with increasing visceral fat in both groups but was more pronounced in the women with previous GDM. Conclusions: Women with GDM are at increased risk of developing prediabetes and have a decreased b-cell function 5 years post-partum that is associated with increased visceral fat mass.

Leptin and adiponectin as predictors of cardiovascular risk after gestational diabetes mellitus

“…The current study is a 5-year follow-up after the index pregnancy [20]. A total of 1031 participants from the original STORK cohort were invited to participate.…”

“…Additional venous blood samples were allowed to clot for 30 min and the serum separated by centrifugation for 10 min at 3000 g and stored at −80 °C. Glucose levels were also measured from frozen serum samples collected at 30–32 weeks using the hexokinase method (Hitachi Modular P800, Roche Diagnostics, Mannheim, Germany) at an accredited clinical chemistry laboratory at Oslo University Hospital Rikshospitalet, as previously reported [20]. For the 5-year follow-up study, we used the glucose data from the Accu-check Sensor glucometer (Roche Diagnostics, Mannheim, Germany).…”

“…For the 5-year follow-up study, we used the glucose data from the Accu-check Sensor glucometer (Roche Diagnostics, Mannheim, Germany). Insulin levels in the stored samples were assayed in duplicate by RIA (Diagnostic Products Corporation, Los Angeles, CA, USA), as previously reported [20]. Levels of apolipoprotein A (apoA), apoB, HDL-C, low density lipoprotein cholesterol (LDL-C) (direct measurements), and triglycerides (TG) were measured from frozen serum samples at follow-up at the clinical chemistry laboratory at Oslo University Hospital Rikshospitalet.…”

“…Total body composition was determined by dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy Densitometer, software version 12.10, GE Medical Systems, Lunar Corp., Madison, WI, USA) and analyzed using enCORE software (version 14.10; GE Medical Systems), as previously described [20]. …”

Adipokines and macrophage markers during pregnancy—Possible role for sCD163 in prediction and progression of gestational diabetes mellitus

“…A 75‐g OGTT was performed on all women at 14 to 16 weeks and 30 to 32 weeks of gestation. A follow‐up OGTT was performed 5‐year postpartum in 300 women . We included only the women that had participated both during pregnancy and follow‐up in this particular study.…”