Insulin Sensitivity, Islet Cell Function, and Incretin Axis in Pregnant Women With and Without Gestational Diabetes Mellitus.

Niya Narayanan, Jayaprakash Sahoo, Sadishkumar Kamalanathan, Haritha Sagili, Bobby Zachariah, Dukhabandhu Naik, Ayan Roy, Chandhana Merugu
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Abstract

Introduction: The aim of this study was to compare insulin sensitivity, islet cell function, and incretin axes in pregnant subjects with GDM and normal healthy controls.

Methods: Pregnant women at 24 to 28 weeks of gestation were subjected to a 75 g oral glucose tolerance test (OGTT). Samples for glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were collected at 0, 30, 60, and 120 min during the OGTT. The Matsuda index (MI) and insulin secretion and sensitivity index-2 (ISSI-2) were assessed. The glucagon suppression index (GSI) was calculated along with the area under the curve (AUC) for glucose, insulin, glucagon, GLP-1, and GIP.

Results: A total of 48 pregnant women (25 GDM and 23 controls) were finally analysed. The MI and ISSI-2 were low in the GDM group [4.31 vs. 5.42; P = 0.04], [1.99 vs. 3.18, P ≤ 0.01] respectively). Total AUCglucagon was higher in the GDM group (7411.7 vs. 6320.1, P = 0.02). GSI30 was significantly lower in the GDM group (-62.6 vs. -24.7, P = 0.03). Fasting GLP-1 levels were low in GDM women (17.3 vs. 22.2, P = 0.04). The total AUCGLP-1 positively correlated with total GSI in the GDM group.

Conclusion: Asian-Indian GDM women have high insulin insensitivity, islet cell dysfunction, and low fasting GLP-1. Incretin axis dysfunction plays a potential role in their islet cell dysfunction.

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患有和未患有妊娠糖尿病的孕妇的胰岛素敏感性、胰岛细胞功能和内分泌轴。
引言本研究旨在比较 GDM 孕妇和正常健康对照组的胰岛素敏感性、胰岛细胞功能和增量素轴:方法:对妊娠 24 至 28 周的孕妇进行 75 克口服葡萄糖耐量试验(OGTT)。在 OGTT 期间的 0、30、60 和 120 分钟采集葡萄糖、胰岛素、胰高血糖素、胰高血糖素样肽-1(GLP-1)和葡萄糖依赖性促胰岛素多肽(GIP)样本。评估了松田指数(MI)和胰岛素分泌与敏感性指数-2(ISSI-2)。计算胰高血糖素抑制指数(GSI)以及葡萄糖、胰岛素、胰高血糖素、GLP-1 和 GIP 的曲线下面积(AUC):最终对 48 名孕妇(25 名 GDM 孕妇和 23 名对照组孕妇)进行了分析。GDM组的MI和ISSI-2较低[分别为4.31 vs. 5.42; P = 0.04]和[分别为1.99 vs. 3.18, P ≤ 0.01])。GDM组的胰高血糖素总AUC较高(7411.7 vs. 6320.1,P = 0.02)。GDM组的GSI30明显降低(-62.6 vs. -24.7,P = 0.03)。GDM 妇女的空腹 GLP-1 水平较低(17.3 vs. 22.2,P = 0.04)。GDM组的总AUCGLP-1与总GSI呈正相关:结论:亚裔印度 GDM 妇女对胰岛素高度不敏感、胰岛细胞功能障碍、空腹 GLP-1 低。胰岛素轴功能障碍可能是导致胰岛细胞功能障碍的原因之一。
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来源期刊
Indian Journal of Endocrinology and Metabolism
Indian Journal of Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
2.10
自引率
0.00%
发文量
75
期刊介绍: The Indian Journal of Endocrinology and Metabolism (IJEM) aims to function as the global face of Indian endocrinology research. It aims to act as a bridge between global and national advances in this field. The journal publishes thought-provoking editorials, comprehensive reviews, cutting-edge original research, focused brief communications and insightful letters to editor. The journal encourages authors to submit articles addressing aspects of science related to Endocrinology and Metabolism in particular Diabetology. Articles related to Clinical and Tropical endocrinology are especially encouraged. Sub-topic based Supplements are published regularly. This allows the journal to highlight issues relevant to Endocrine practitioners working in India as well as other countries. IJEM is free access in the true sense of the word, (it charges neither authors nor readers) and this enhances its global appeal.
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