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Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes
OBJECTIVE: To describe the metabolic characteristics of gestational diabetes mellitus (GDM) and assess their effects on perinatal outcomes. METHODS: A two-center nested case‒control study was designed, including 192 pregnant women with GDM and 191 pregnant women with normal glucose tolerance (NGT)....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843504/ https://www.ncbi.nlm.nih.gov/pubmed/36760593 http://dx.doi.org/10.2147/DMSO.S390999 |
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author | Luo, Ping Fan, Ying Xiong, Yusha Zhang, Chunlin Yang, Zhiping Sun, Fenglan Mei, Bing |
author_facet | Luo, Ping Fan, Ying Xiong, Yusha Zhang, Chunlin Yang, Zhiping Sun, Fenglan Mei, Bing |
author_sort | Luo, Ping |
collection | PubMed |
description | OBJECTIVE: To describe the metabolic characteristics of gestational diabetes mellitus (GDM) and assess their effects on perinatal outcomes. METHODS: A two-center nested case‒control study was designed, including 192 pregnant women with GDM and 191 pregnant women with normal glucose tolerance (NGT). Serum glucose and insulin concentrations based upon the 75 g oral glucose tolerance test (OGTT) were measured. Several indices were calculated to describe the metabolic characteristics of the subjects. The relationship between glucose metabolism parameters and pregnancy outcomes was evaluated using stepwise linear regression and binary logistic regression. RESULTS: Compared with the NGT group, the GDM group showed significantly higher fasting and postprandial glucose parameters but significantly lower fasting and postprandial insulin responses. Meanwhile, the GDM group had significantly lower HOMA-β, DI and ISI(Matsuda) but comparable HOMA-IR. The IFG subgroup showed significantly lower FINS/FPG only, while the IGT and IFSG subgroups showed deficiency in both fasting and postprandial insulin response. The IFSG subgroup had the highest glucose parameters and the lowest insulin parameters, as well as significantly lower ISI(Matsuda) and HOMA-β than the NGT group. FPG had a significant effect on infants’ birth weight, and 1hPG and FINS/FPG had a significant effect on delivery gestational age. AUC-INS, IGI(60) and DI were related to premature delivery risk after adjusting for confounders. The IFG subgroup of GDM was 2.319 times more likely to be subject to cesarean section than the NGT group. FPG, FINS/FPG, AUC-GLU, AUC-INS/AUC-GLU and HOMA-β were related to macrosomia risk. CONCLUSION: Beta cell dysfunction rather than insulin resistance determines the occurrence of GDM in the central Chinese population. Women with predominant insulin secretion defects had a similar risk of adverse perinatal outcomes to women with NGT. Our study provided a basis for the selection of glucose metabolism monitoring indicators useful for the prevention of adverse perinatal outcomes. |
format | Online Article Text |
id | pubmed-9843504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-98435042023-02-08 Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes Luo, Ping Fan, Ying Xiong, Yusha Zhang, Chunlin Yang, Zhiping Sun, Fenglan Mei, Bing Diabetes Metab Syndr Obes Original Research OBJECTIVE: To describe the metabolic characteristics of gestational diabetes mellitus (GDM) and assess their effects on perinatal outcomes. METHODS: A two-center nested case‒control study was designed, including 192 pregnant women with GDM and 191 pregnant women with normal glucose tolerance (NGT). Serum glucose and insulin concentrations based upon the 75 g oral glucose tolerance test (OGTT) were measured. Several indices were calculated to describe the metabolic characteristics of the subjects. The relationship between glucose metabolism parameters and pregnancy outcomes was evaluated using stepwise linear regression and binary logistic regression. RESULTS: Compared with the NGT group, the GDM group showed significantly higher fasting and postprandial glucose parameters but significantly lower fasting and postprandial insulin responses. Meanwhile, the GDM group had significantly lower HOMA-β, DI and ISI(Matsuda) but comparable HOMA-IR. The IFG subgroup showed significantly lower FINS/FPG only, while the IGT and IFSG subgroups showed deficiency in both fasting and postprandial insulin response. The IFSG subgroup had the highest glucose parameters and the lowest insulin parameters, as well as significantly lower ISI(Matsuda) and HOMA-β than the NGT group. FPG had a significant effect on infants’ birth weight, and 1hPG and FINS/FPG had a significant effect on delivery gestational age. AUC-INS, IGI(60) and DI were related to premature delivery risk after adjusting for confounders. The IFG subgroup of GDM was 2.319 times more likely to be subject to cesarean section than the NGT group. FPG, FINS/FPG, AUC-GLU, AUC-INS/AUC-GLU and HOMA-β were related to macrosomia risk. CONCLUSION: Beta cell dysfunction rather than insulin resistance determines the occurrence of GDM in the central Chinese population. Women with predominant insulin secretion defects had a similar risk of adverse perinatal outcomes to women with NGT. Our study provided a basis for the selection of glucose metabolism monitoring indicators useful for the prevention of adverse perinatal outcomes. Dove 2023-01-11 /pmc/articles/PMC9843504/ /pubmed/36760593 http://dx.doi.org/10.2147/DMSO.S390999 Text en © 2023 Luo et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Luo, Ping Fan, Ying Xiong, Yusha Zhang, Chunlin Yang, Zhiping Sun, Fenglan Mei, Bing Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title | Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title_full | Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title_fullStr | Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title_full_unstemmed | Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title_short | Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes |
title_sort | metabolic characteristics of gestational diabetes mellitus and the effects on pregnancy outcomes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843504/ https://www.ncbi.nlm.nih.gov/pubmed/36760593 http://dx.doi.org/10.2147/DMSO.S390999 |
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