Introduction: There is growing evidence that gestational diabetes mellitus (GDM) significantly increases the risk of adverse consequences, the most significant of which is a predisposition to the development of metabolic syndrome and diabetes mellitus (DM). The reasons why some women develop DM, while the others not, are still studied. The relationship between various metabolic parameters and GDM might be closely associated.
Aim: To evaluate the coherence of carbohydrate metabolism and metabolic parameters (adipocytokines, incretins, insulin resistance) in women with previously diagnosed GDM.
Methods: We examined 126 women with previously (1643 years ago) diagnosed GDM. BMI was evaluated. Fasting plasma glucose (FPG) was examined for women with DM. OGTT was performed for carbohydrate metabolism testing for the rest. Women assigned to different groups: NG normal glucose, IFG-IGT impaired fasting glucose/impaired glucose tolerance and DM group. Incretins, adipocytokines were evaluated. IR was calculated with HOMA-IR index. Data expressed as mean±SD for parametric data or median (min-max) for non-parametric data. ANOVA was used to compare data between groups of three or more variables. Non-parametric data correlation analysis was performed using the Spearmans correlation coefficient. The results were considered statistically significant at P<0.05.
Results: Womens average age was 53.52±8.34 years (3977 years). Age differed in separate carbohydrate metabolism groups (P=0.001). Carbohydrate metabolism was set for 58%: IFG-IGT for 16.7%, DM for 41.3% patients. The correlation between adipocytokines, incretins and FPG was evaluated: higher FPG was seen in women with lower adiponectin (r=−0.186, P=0.037), higher leptin levels (r=0.340 P<0.01) as well as incretins concentrations (GIP r=0.368, P<0.01 and GLP-1 r=0.05, P=0.004) and HOMA-IR (r=0.656,P<0.01). Data analysed in different carbohydrate metabolism groups (NG/IFG-IGT/DM): BMI (26.7 (18.852.2)/27.9 (20.152.9)/34.8 (20.552.9), P=0.001), adiponectin (21.6 (10.376.8)/18.7 (9.954.4)/17.7 (5.252.9), P=0.07), leptin (14.7 (0.274.9)/10.9 (2.248.6)/19.6 (1.666.3), P=0.327), GIP (0.8(0.212.1)/0.8 (0.25.2)/0.07 (0.0521.7), P=0.416), GLP-1 (0.06 (0.0416.6)/0.07 (0.045.4)/0.07 (0.0521.7), P=0.044), HOMA-IR (2.3 (0.54.7)/2.4 (1.47.2)/4.5 (0.527.2), P<0.01).
Conclusion: Age, BMI, adipocytokines, incretins and IR are closely linked to the carbohydrate metabolism: IFG-IGT and DM was more frequently seen in elder overweight/obese women, having lower adiponectin, higher GLP-1 concentration and higher HOMA-IR.
20 - 23 May 2017
European Society of Endocrinology