Insulin sensitivity, β cell function, and adverse pregnancy outcomes in women with gestational diabetes
10.1097/CM9.0000000000002337
- VernacularTitle:Insulin sensitivity, β cell function, and adverse pregnancy outcomes in women with gestational diabetes
- Author:
Yun SHEN
1
;
Yanwei ZHENG
;
Yingying SU
;
Susu JIANG
;
Xiaojing MA
;
Jiangshan HU
;
Changbin LI
;
Yajuan HUANG
;
Yincheng TENG
;
Yuqian BAO
;
Minfang TAO
;
Jian ZHOU
Author Information
1. Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
- Keywords:
β cell function;
Insulin sensitivity;
Adverse pregnancy outcomes
- From:
Chinese Medical Journal
2022;135(21):2541-2546
- CountryChina
- Language:Chinese
-
Abstract:
Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.
