Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women

Catalano, Patrick M.; Tyzbir, Elaine D.; Roman, Noreen M.; Amini, Saeid B.; Sims, Ethan A. H.

doi:10.1016/0002-9378(91)90012-g

Cited by 625 publications

(437 citation statements)

References 15 publications

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“…Consequently, the insulin response to oral carbohydrate is elevated and basal insulin production increases, producing an overall 2-3-fold rise in mean insulin concentrations over any 24 h period. 58,59 The naturally insulin resistant state of late pregnancy provides an adaptive mechanism, supplying sufficient fuel to support the placenta and fetal development. A state of normal insulin sensitivity is restored in the immediate puerperium.…”

Section: Maternal Metabolism During Pregnancymentioning

confidence: 99%

“…This profound insulin resistance produces a pathological response, resulting in maternal hyperinsulinaemia, hyperglycaemia and gestational diabetes mellitus. [58][59][60] Exaggerated hyperlipidaemia also occurs during obese pregnancy. VLDL concentrations are increased compared with normal pregnancy and the appearance and oxidation of small LDL particles is characteristic.…”

Section: Maternal Metabolism During Pregnancymentioning

confidence: 99%

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The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Dennedy

Dunne

2010

Best Practice & Research Clinical Endocrinology & Metab

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Section: Maternal Metabolism During Pregnancymentioning

confidence: 99%

Section: Maternal Metabolism During Pregnancymentioning

confidence: 99%

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Dennedy

Dunne

2010

Best Practice & Research Clinical Endocrinology & Metab

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“…During gestation, there is a gradual decrease in insulin sensitivity (1). A variety of endocrine factors including estrogens, progesterone, human placental lactogen, cortisol, and tumor necrosis factor-a seem to impair the effect of insulin (2,3).…”

Section: Introductionmentioning

confidence: 99%

Overweight is associated with impaired β-cell function during pregnancy: a longitudinal study of 553 normal pregnancies

Qvigstad

Voldner²,

Godang³

et al. 2010

European Journal of Endocrinology

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Objective: To monitor b-cell function and insulin sensitivity longitudinally in a large cohort of pregnant women to elucidate mechanisms that influence glycemic control in pregnancy. Design and methods: Five hundred and fifty-three pregnant Scandinavian women underwent 75 g oral glucose tolerance test (OGTT) at weeks 14-16 and 30-32. Insulin sensitivity (Matsuda index) and b-cell function (ratio of AUC insulin to AUC glucose , AUC ins/glc ) were calculated from 520 complete tests, and subsequently b-cell function was adjusted for insulin sensitivity, rendering an oral disposition index (DI o ). Results: Eleven women (2.1%) had gestational diabetes mellitus (GDM1) at weeks 14-16, and 49 (9.4%) at weeks 30-32 (GDM2), which is higher than that previously reported in this region. In the subdivision of OGTT, more overweight (body mass indexO25) was found in glucose-intolerant groups (glucose-tolerant women (normal glucose tolerance, NGT) 38 versus GDM2 women 58 and GDM1 women 82%, P!0.005). In early pregnancy, insulin sensitivity was lowest in GDM1, intermediate in GDM2, and highest in NGT. In late pregnancy, insulin sensitivity decreased in all groups, most in gestational diabetes. b-cell function demonstrated minor shifts during pregnancy, but when adjusted for decreasing insulin sensitivity, DI o levels fell by 40% (P!0.001). DI o was significantly attenuated relative to glucose intolerance (GDM1 25% and GDM2 53%) during pregnancy. In overweight women, DI o levels were lower throughout pregnancy (P!0.001 versus normal weight women), this reduction was significant (P!0.01) in both NGT (21-25%) and GDM2 subjects (26-49%). Conclusion: b-cell function adjusted for insulin sensitivity (DI o ) deteriorated during pregnancy in both glucose-tolerant and glucose-intolerant women. The failure to compensate the decrease in insulin sensitivity was accentuated in overweight women.

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“…[1][2][3] The mechanisms responsible for the gestational-induced insulin resistance are not completely understood; however, previous studies suggested that increased concentrations of several hormones, including estrogen, progesterone, cortisol and human placental lactogen are plausible mediators of insulin resistance during pregnancy. 4 Lately, studies have implicated that adipocytokines, such as tumor necrosis factor alpha (TNF)-a) and leptin, are probable regulators of insulin resistance in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Maternal serum adiponectin levels during human pregnancy

et al. 2007

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Objective: Pregnancy is a unique situation characterized by insulin resistance. The role of adiponectin, an insulin-sensitizing hormone, has not been completely clarified during pregnancy. The aim of this cross-sectional study was to evaluate adiponectin levels during pregnancy and postpartum. Study design:Adiponectin and leptin levels were tested in 80 pregnant women, 20 in each trimester (mean gestational age 10.5±1.9; 19.3±4.9; 39.3±0.8 weeks,) as well as 4 days postpartum.Results: Adiponectin levels during first (13.3±3.6 mg/ml), second (12.6±4.4 mg/ml) and third trimester (11.2±3.7 mg/ml) did not differ and were significantly higher than postpartum levels (8.8±2.1 mg/ml; P<0.0001, P<0.004 and P<0.02, respectively). Conclusion:Despite increased insulin resistance during pregnancy, no significant alterations in adiponectin levels were observed. This may imply that the regulation of adiponectin during gestation is altered. The elevated gestational adiponectin levels are consistent with increased 'adiponectin resistance' during pregnancy.

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Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women

Cited by 625 publications

References 15 publications

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Overweight is associated with impaired β-cell function during pregnancy: a longitudinal study of 553 normal pregnancies

Maternal serum adiponectin levels during human pregnancy

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