Hepatic Insulin Resistance Is an Early Determinant of Declining ß-Cell Function in the First Year Postpartum After Glucose Intolerance in Pregnancy  

Oleh:

Retnakaran, Ravi ; Qi, Ying ; Chang Ye ; Hanley, Anthony J. G.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 34 no. 11 (Nov. 2011), page 2431-2434 .
Topik: DIABETES; Hepatic Insulin Resistance; Women Diabetes; Pregnancy

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE The increased risk of type 2 diabetes in women with glucose intolerance in pregnancy is mediated by deterioration of their ß-cell function, which occurs as early as the first year postpartum. We thus sought to identify early determinants of their declining ß-cell function. RESEARCH DESIGN AND METHODS Women with recent gestational glucose intolerance (166) underwent oral glucose tolerance test at 3 and 12 months postpartum. They were stratified into those in whom ß-cell function (Insulin Secretion-Sensitivity Index-2 [ISSI-2]) declined over this time (decliners; n = 92) and those in whom it did not (nondecliners; n = 74). RESULTS Between 3 and 12 months, hepatic insulin sensitivity (1/homeostasis model assessment of insulin resistance [HOMA-IR]) decreased in decliners but not in nondecliners. Over this time, the change in 1/HOMA-IR emerged as an independent predictor of the change in ISSI-2 (t = 5.5; P < 0.0001). Increased hepatic insulin sensitivity independently predicted a lower likelihood of declining ß-cell function (odds ratio = 0.13 [95% CI 0.06–0.29]; P < 0.0001). CONCLUSIONS Hepatic insulin resistance is an early determinant of declining ß-cell function after gestational dysglycemia.

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