Journal Article

Hormonal and Metabolic Factors Associated With Variations in Insulin Sensitivity in Human Pregnancy

Cowley, David M, Dyer, Alan R, Chang, Allan M, Kirwan, John P, Radaelli, Tatjana, Catalano, Patrick M, Amini, Saeid B, Callaway, Leonie K, McIntyre, H. David, Huston-Presley, Larraine, Farrell, Kristen A

2010

Overview

OBJECTIVE: The objective of this study was to determine maternal hormonal and metabolic factors associated with insulin sensitivity in human pregnancy. RESEARCH DESIGN AND METHODS: This was a prospective observational cross-sectional study of 180 normal pregnant women, using samples collected at the time of a blinded oral glucose tolerance test (OGTT) between 24 and 32 weeks' gestation as an ancillary to the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. The study was conducted at two public university teaching hospitals, Cleveland, Ohio, and Brisbane, Australia. Fasting maternal serum cholesterol, triglycerides, free fatty acids, insulin, leptin, tumor necrosis factor-α, placental growth hormone (PGH), insulin-like growth factors (IGFs) 1 and 2, and insulin-like growth factor binding proteins (IGFBPs) 1 and 3 were assayed. Correlation and multiple regression analyses were used to determine factors associated with maternal insulin sensitivity (IS) estimated using both OGTT-derived (ISOGTT) and fasting (using the homeostasis model assessment [HOMA]; ISHOMA) insulin and glucose concentrations. RESULTS: Insulin sensitivity correlated (r = x and y for ISOGTT and ISHOMA, respectively) with fasting maternal serum leptin (-0.44 and -0.52), IGFBP1 (0.42 and 0.39), and triglycerides (-0.31 and -0.27). These factors were significantly associated with insulin sensitivity in multiple regression analyses (adjusted R² 0.44 for ISOGTT and ISHOMA). These variables explained more than 40% of the variance in estimates of insulin sensitivity. CONCLUSIONS: Maternal hormonal and metabolic factors related to the placenta, adipose tissue, and the growth hormone axis are associated with the variation in insulin sensitivity seen during normal human pregnancy.

• Publisher: American Diabetes Association
• Subject: adipose tissue / Adult / Australia / Biological and medical sciences / blood / blood serum / Body Mass Index / cholesterol / Cholesterol - blood / Cross-Sectional Studies / Dextrose / Diabetes / Diabetes. Impaired glucose tolerance / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / fasting / Fatty acids / Fatty Acids, Nonesterified / Fatty Acids, Nonesterified - blood / Female / free fatty acids / Glucose / glucose tolerance / Glucose Tolerance Test / Glucose tolerance tests / homeostasis / hospitals / Humans / Hyperglycemia / Insulin / Insulin - blood / insulin resistance / Insulin-Like Growth Factor Binding Protein 3 / Insulin-Like Growth Factor Binding Protein 3 - blood / insulin-like growth factor binding proteins / Insulin-Like Growth Factor Binding Proteins - blood / Insulin-Like Growth Factor I / Insulin-Like Growth Factor I - metabolism / Insulin-Like Growth Factor II / Insulin-Like Growth Factor II - metabolism / Leptin / Leptin - blood / Medical sciences / Metabolic diseases / metabolism / Miscellaneous / necrosis / Nutrition / Ohio / Original Research / Peptide hormones / placenta / Pregnancy / Pregnancy - blood / pregnancy outcome / Pregnant women / Prospective Studies / Public health. Hygiene / Public health. Hygiene-occupational medicine / Regression Analysis / somatomedins / Somatotropin / triacylglycerols / Triglycerides / Triglycerides - blood / Tumor necrosis factor / tumor necrosis factor-alpha / Tumor Necrosis Factor-alpha - blood / variance / Womens health