Dataset Information

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia.

ABSTRACT: The postpartum phase following gestational diabetes (GDM) is characterised by subtle metabolic defects, including the beta cell dysfunction that is believed to mediate the increased future risk of type 2 diabetes in this patient population. Low circulating levels of adiponectin and increased leptin and C-reactive protein (CRP) have recently emerged as novel diabetic risk factors, although their relevance to GDM and subsequent diabetes has not been characterised. Thus, we sought to determine whether adiponectin, leptin and CRP levels during pregnancy relate to the postpartum metabolic defects linking GDM with type 2 diabetes.Metabolic characterisation, including oral glucose tolerance testing, was undertaken in 487 women during pregnancy and at 3 months postpartum. Based on the antepartum OGTT, there were 137 women with GDM, 91 with gestational impaired glucose tolerance and 259 with normal glucose tolerance.Adiponectin levels were lowest (p < 0.0001) and CRP levels highest (p = 0.0008) in women with GDM. Leptin did not differ between the glucose tolerance groups (p = 0.4483). Adiponectin (r = 0.41, p < 0.0001), leptin (r = -0.36, p < 0.0001) and CRP (r = -0.30, p < 0.0001) during pregnancy were all associated with postpartum insulin sensitivity (determined using the insulin sensitivity index of Matsuda and DeFronzo [IS(OGTT)]). Intriguingly, adiponectin levels were also related to postpartum beta cell function (insulinogenic index/HOMA of insulin resistance; r = 0.16, p = 0.0009). Indeed, on multiple linear regression analyses, adiponectin levels during pregnancy independently predicted both postpartum insulin sensitivity (t = 3.97, p < 0.0001) and beta cell function (t = 2.37, p = 0.0181), even after adjustment for GDM. Furthermore, adiponectin emerged as a significant negative independent determinant of postpartum fasting glucose (t = -3.01, p = 0.0027).Hypoadiponectinaemia during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia, and hence may be relevant to the pathophysiology relating GDM with type 2 diabetes.

SUBMITTER: Retnakaran R

PROVIDER: S-EPMC2878328 | biostudies-literature | 2010 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia.

Retnakaran R R Qi Y Y Connelly P W PW Sermer M M Hanley A J AJ Zinman B B

Diabetologia 20091124 2

<h4>Aims/hypothesis</h4>The postpartum phase following gestational diabetes (GDM) is characterised by subtle metabolic defects, including the beta cell dysfunction that is believed to mediate the increased future risk of type 2 diabetes in this patient population. Low circulating levels of adiponectin and increased leptin and C-reactive protein (CRP) have recently emerged as novel diabetic risk factors, although their relevance to GDM and subsequent diabetes has not been characterised. Thus, we ...[more]

PMID: 19937225

Similar Datasets

Project description:INTRODUCTION:Sexual function and frequency can change between couples during pregnancy and postpartum, with a decline in sexual function in women. AIM:To investigate sexual function in couples during pregnancy and postpartum. METHODS:This questionnaire-based cross-sectional descriptive study solicited data from 551 couples, 127 (23%) of whom responded: 15 during the first trimester; 26 during the second trimester; and 21, 22, 21, and 22 at 1, 3, 6, and 12 months postpartum, respectively. The Female Sexual Function Index (FSFI) and International Index for Erectile Function (IIEF) questionnaires were used for female and male participants, respectively, and included questions about delivery, breastfeeding, partner's contribution to housework, and desire to have more children for women, and about aspects of their partner's pregnancy and postpartum life for men. Data about maternal/paternal age, parity, body mass index, and mode of delivery were also collected. MAIN OUTCOME MEASURE:FSFI and IIEF total and subcategory scores with attributable factors. RESULTS:The total and subcategory scores related to female and male sexual functions were lowest at 1 and 3 months postpartum, with 79 women reporting female sexual dysfunction (score <26.55). The FSFI subcategory scores (except desire and satisfaction) differed between 1 and 12 months postpartum. The IIEF scores showed no significant differences. The total mean IIEF scores were 17.9 ± 9.6 and 54.9 ± 12.0 in men with and without erectile dysfunction (ED), respectively. The FSFI scores were 8.6 ± 7.2 and 18.2 ± 8.6 in women whose partner had and did not have ED, respectively. No significant differences (P = .76) were observed between the male satisfaction subcategories. CONCLUSION:Sexual function decreased around the time of delivery for men and women, but did not correlate with the sexual satisfaction of men. Type of delivery, breastfeeding, intimacy, and partner's contribution to housework did not affect sexual dysfunction. Saotome TT, Yonezawa K, Suganuma N. Sexual dysfunction and satisfaction in Japanese couples during pregnancy and postpartum. Sex Med 2018;6:348-355.

Project description:BackgroundMembers of the aging population who undergo surgery are at risk of postoperative cognitive dysfunction (POCD). Exploring an effective and reliable early predictor of POCD is essential to the identification of high-risk patients and to making prospective decisions. The purpose of this study was to examine whether preoperative insulin resistance is an independent predictor of POCD.MethodsA total of 124 patients aged 60 years and older and who were scheduled for gastrointestinal surgery were enrolled in a prospective observational clinical study. All participants completed a battery of neuropsychological tests before surgery and 7 days later. POCD was defined as a decline of at least 1.5 SD on two or more of neuropsychological tests. Plasma concentration of the tumor necrosis factor α (TNF-α), C-reactive protein (CRP), and S-100β protein were measured. The status of insulin resistance was assessed by Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). The relationship between HOMA-IR and POCD was assessed by Multivariable logistic regression models and the receiver operating characteristic (ROC) curve.ResultsFifty one patients (41.1%) were diagnosed with POCD at 7 days after surgery. Preoperative HOMA-IR values of the POCD group were significantly higher than the non-POCD group. Furthermore, CRP and TNF-α levels of the POCD group were significantly higher at each postoperative time point (P < 0.05). The preoperative HOMA-IR value was an independent predictor of POCD (adjusted OR 1.88, 95% CI, 1.18-2.99) even after adjust for confounding variables, and when dichotomized, individuals above the HOMA-IR threshold (HOMA-IR > 2.6) had a three-times higher risk of POCD (OR 3.26; 95% CI, 1.07-9.91) compared to individuals below the threshold. The areas under the ROC curve of HOMA-IR was 0.804 (95% CI, 0.725-0.883; P < 0.001). The optimal cut-off value was found to be 0.583, with a sensitivity of 84.3% and specificity of 74%. The HOMA-IR value was positively associated with the TNF-α concentration at baseline (R 2 = 0.43, P < 0.01) and 1 day after surgery (R 2 = 0.3861, P < 0.01).ConclusionPreoperative insulin resistance is an effective predictor for the occurrence of POCD. Targeted prevention and treatment strategies of insulin resistance may be effective interventions of patients at risk for POCD.

Dataset Information

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia.

Publications

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets