Titre
C-reactive protein during pregnancy and in the early postpartum predicts adverse metabolic health outcomes at 1 year postpartum in women with gestational diabetes.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Quansah, D.Y.
Auteure/Auteur
Horsch, A.
Auteure/Auteur
Gilbert, L.
Auteure/Auteur
Donath, M.Y.
Auteure/Auteur
Puder, J.J.
Auteure/Auteur
Contributrices/contributeurs
Arhab, A.
Bovet, P.
Chiolero, A.
Di Bernardo, S.
Epure, A.M.
Younes, S.E.
Gilbert, L.
Gross, J.
Horsch, A.
Lanzi, S.
Mayerat, S.
Mivelaz, Y.
Puder, J.J.
Quansah, D.Y.
Rossel, J.B.
Sekarski, N.
Simeoni, U.
Stuijfzand, B.
Via, Y.
Groupes de travail
MySweetheart research group
ISSN
1475-2840
Statut éditorial
Publié
Date de publication
2023-10-27
Volume
22
Numéro
1
Première page
291
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Publication Status: epublish
Résumé
Women with gestational diabetes mellitus (GDM) have higher insulin resistance and/or reduced secretion, an increased risk of future diabetes and cardiovascular disease, which may be due to a pathological activation of the innate immune system. C-reactive protein (CRP) is induced by inflammatory cytokines and reflects innate immune activity. We investigated the prospective associations between CRP during the perinatal period with adverse metabolic outcomes at 1 year postpartum in women with previous GDM.
We analyzed data from the MySweetheart trial that included 211 women with GDM at 28-32 weeks gestational age (GA). CRP was measured during pregnancy at 28-32 weeks GA, at 6-8 weeks and at 1 year postpartum. Metabolic outcomes at 1 year postpartum included weight, total and central body fat, measures of insulin resistance and secretion and presence of the metabolic syndrome (MetS). A 75 g oral glucose tolerance test was performed to measure glucose and insulin values every 30 min over 2 h to calculate indices of insulin resistance (MATSUDA, HOMA-IR) and of absolute (AUC <sub>ins/glu</sub> , HOMA-B) and insulin resistance-adjusted insulin secretion (ISSI-2).
CRP during pregnancy and at 6-8 weeks postpartum predicted increased weight, body fat and visceral adipose tissue (VAT), insulin resistance (higher HOMA-IR, lower MATSUDA), absolute insulin secretion (HOMA-B, AUC <sub>ins/glu</sub> ), a reduced adjusted insulin secretion (ISSI-2) and a higher prevalence of the MetS at 1 year postpartum (all p ≤ 0.036). These relationships particularly those concerning CRP during pregnancy, were independent of weight ( for VAT, insulin resistance and secretion indices, MetS; all p ≤ 0.032) and of body fat ( for VAT, MATSUDA, MetS; all p ≤ 0.038). CONCLUSION: CRP during pregnancy and in the early postpartum predicted an adverse cardio-metabolic profile in women with prior GDM at 1 year postpartum independent of weight. The prospective association of CRP with increased insulin resistance and reduced adjusted insulin secretion hint to the role of inflammation in the development of impaired metabolism after GDM and could be used as an early marker for risk stratification.
We analyzed data from the MySweetheart trial that included 211 women with GDM at 28-32 weeks gestational age (GA). CRP was measured during pregnancy at 28-32 weeks GA, at 6-8 weeks and at 1 year postpartum. Metabolic outcomes at 1 year postpartum included weight, total and central body fat, measures of insulin resistance and secretion and presence of the metabolic syndrome (MetS). A 75 g oral glucose tolerance test was performed to measure glucose and insulin values every 30 min over 2 h to calculate indices of insulin resistance (MATSUDA, HOMA-IR) and of absolute (AUC <sub>ins/glu</sub> , HOMA-B) and insulin resistance-adjusted insulin secretion (ISSI-2).
CRP during pregnancy and at 6-8 weeks postpartum predicted increased weight, body fat and visceral adipose tissue (VAT), insulin resistance (higher HOMA-IR, lower MATSUDA), absolute insulin secretion (HOMA-B, AUC <sub>ins/glu</sub> ), a reduced adjusted insulin secretion (ISSI-2) and a higher prevalence of the MetS at 1 year postpartum (all p ≤ 0.036). These relationships particularly those concerning CRP during pregnancy, were independent of weight ( for VAT, insulin resistance and secretion indices, MetS; all p ≤ 0.032) and of body fat ( for VAT, MATSUDA, MetS; all p ≤ 0.038). CONCLUSION: CRP during pregnancy and in the early postpartum predicted an adverse cardio-metabolic profile in women with prior GDM at 1 year postpartum independent of weight. The prospective association of CRP with increased insulin resistance and reduced adjusted insulin secretion hint to the role of inflammation in the development of impaired metabolism after GDM and could be used as an early marker for risk stratification.
Sujets
PID Serval
serval:BIB_3E7BEEBC2044
PMID
Open Access
Oui
Date de création
2023-10-29T06:21:10.351Z
Date de création dans IRIS
2025-05-20T17:26:38Z
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Nom
Quansah_2023_Cardiovascular_Diabetology.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
901.39 KB
Format
Adobe PDF
PID Serval
serval:BIB_3E7BEEBC2044.P001
URN
urn:nbn:ch:serval-BIB_3E7BEEBC20447
Somme de contrôle
(MD5):44fca4522aa5ace24986ad2983bc5cef