β-Cell function or insulin resistance was associated with the risk of type 2 diabetes among women with or without obesity and a history of gestational diabetes.

Abstract

INTRODUCTION:

To evaluate the single association of postpartum β-cell dysfunction and insulin resistance (IR), as well as different combinations of postpartum β-cell dysfunction, IR, obesity, and a history of gestational diabetes mellitus (GDM) with postpartum type 2 diabetes risk.

RESEARCH DESIGN AND METHODS:

The study included 1263 women with prior GDM and 705 women without GDM. Homeostatic model assessment was used to estimate homeostatic model assessment of β-cell secretory function (HOMA-%β) and homeostatic model assessment of insulin resistance (HOMA-IR).

RESULTS:

Multivariable-adjusted ORs of diabetes across quartiles of HOMA-%β and HOMA-IR were 1.00, 1.46, 2.15, and 6.25 (ptrend <0.001), and 1.00, 2.11, 5.59, and 9.36 (ptrend <0.001), respectively. Women with IR only had the same diabetes risk as women with β-cell dysfunction only. Obesity, together with IR or β-cell dysfunction, had a stronger effect on diabetes risk. This stronger effect was also found for a history of GDM with IR or β-cell dysfunction. Women with three risk factors, including obesity, a history of GDM and β-cell dysfunction/IR, showed the highest ORs of diabetes.

CONCLUSIONS:

β-cell dysfunction or IR was significantly associated with postpartum diabetes. IR and β-cell dysfunction, together with obesity and a history of GDM, had the highest ORs of postpartum diabetes risk.

• Authors: Yuxin Fan, Leishen Wang, Huikun Liu, Shuang Zhang, Huiguang Tian, Yun Shen, Jaakko Tuomilehto, Zhijie Yu, Xilin Yang, Gang Hu, Ming Liu
• Journal: BMJ open diabetes research & care (BMJ Open Diabetes Res Care) Vol. 8 Issue 1 (09 2020) ISSN: 2052-4897 [Electronic] England
• PMID: 32900701 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Diabetes Mellitus, Type 2 (epidemiology)
• Diabetes, Gestational (epidemiology)
• Female
• Humans
• Insulin Resistance
• Insulin-Secreting Cells
• Obesity (complications, epidemiology)
• Pregnancy