Related factors of postpartum glucose metabolism in gestational diabetes

Abstract:

Objective：To analyze the results of the 75 g oral glucose tolerance test（OGTT） in gestational diabetes mellitus （GDM） at 6 weeks after delivering and to investigate the relationships between the results of OGTT and adiponectin，pregnancy related index. Methods：Clinical data of 36 women with GDM in our hospital from 2011 April to 2011 November were collected and retrospectively analyzed. According to the results of 75 g OGTT at 6 weeks after delivering，the patients were reclassified into two groups：normal group（Ⅰ group） and abnormal group（Ⅱ group）. Levels of leptin，adiponectin and fasting insulin were detected and pregnancy relat－ed index and 6 weeks postpartum glucose metabolism were analyzed. Results：According to the results of pregnancy related index，inci－dence of family diabetes history was lower in Ⅰ group than in Ⅱ group（P<0.05） and the mean GDM diagnosing time was significant－ly later in Ⅰ group than in Ⅱ group（P<0.05）. There was no significant difference in pregnant age，pregnant BMI，fasting blood glu－cose level when making definite diagnosis between two groups（P >0.05）. Based on the clinical indicators，level of postpartum fasting blood glucose was much lower in Ⅰ group than in Ⅱgroup（P<0.05） and the mean leptin concentration was significantly higher in Ⅰ group than in Ⅱ group（P<0.05）. There was no significant difference in age，BMI，fasting insulin level，adiponectin and homeostasis model assessment-insulin resistance（HOMA-IR） between two groups（P >0.05）. Multiple Logistic regression model showed that the leptin concentration was negatively correlated with fasting blood glucose（R=-0.51，P=0.02） and was positively correlated with HOMA-IR（R=0.7，P=0.003）. There was no significant correlation between BMI，age，adiponectin and fasting blood glucose，HOMA-IR. Conclusions：（1）Fasting blood glucose is much lower inⅠ group than in Ⅱ group while leptin concentration is significantly high－er in Ⅰ group than in Ⅱ group.（2）Leptin concentration is negatively correlated with fasting blood glucose but is positively correlated with HOMA-IR. Leptin could act on GDM through the varying of HOMA-IR and increased postpartum leptin level can be a new target in recovery of GDM in the future. （3）There was no significant correlation between adiponectin and BMI，fasting blood glucose. （4）Dignosing time of GDM and family history of diabetes mellitus are the risk factors that trigger postpartum abnormal blood glucose of GDM patients.