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Evaluation of Circulating Determinants of Beta-Cell Function in Women With and Without Gestational Diabetes
Ravi Retnakaran1, Chang Ye1, Caroline K Kramer1
1Leadership Sinai Centre for Diabetes (R.R., C.Y., C.K.K., A.J.H., B.Z.), Mt Sinai Hospital, Toronto, Ontario, Canada; Division of Endocrinology (R.R., C.K.K., P.W.C., A.J.H., B.Z.), University of Toronto, Toronto, Ontario, Canada; Lunenfeld-Tanenbaum Research Institute (R.R., B.Z.), Mt Sinai Hospital, Toronto, Canada; Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), Toronto, Canada; Department of Nutritional Sciences (A.J.H.), University of Toronto, Toronto, Ontario, Canada; and Division of Obstetrics and Gynecology (M.S.), Mt Sinai Hospital, Toronto, Canada.
Context:
Gestational diabetes (GDM) arises in women in whom there is insufficient β-cell compensation for the insulin resistance of late pregnancy. The mechanisms underlying both normal antepartum β-cell adaptation and its aberrancy in GDM are unclear. Preclinical studies have suggested that the hormones prolactin and human placental lactogen (HPL) may stimulate β-cell mass, whereas the furan fatty acid metabolite 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) has recently emerged as a potential negative regulator of β-cell function. However, there has been limited study of these factors in humans.
Objective:
Our objective was to systematically evaluate HPL, prolactin, and CMPF in relation to glucose homeostasis and β-cell function in women with and without GDM.
Design/Setting/Participants:
Three-hundred-and-ninety-five women underwent an oral glucose tolerance test in late pregnancy, enabling assessment of GDM status, glycemia (area-under-the-glucose-curve on oral glucose tolerance test [AUCglucose]), β-cell function (Insulin Secretion-Sensitivity Index-2, insulinogenic index/homeostatic model assessment of insulin resistance [HOMA-IR]), insulin sensitivity/resistance (Matsuda index, HOMA-IR), and circulating HPL, prolactin, and CMPF.
Results:
Serum concentrations of HPL, prolactin, and CMPF were similar between women with GDM (n = 105) and women without GDM (n = 290). However, on multiple linear regression analyses, CMPF emerged as a significant predictor of AUCglucose in women with GDM (t = 4.75, P < .0001) but not in their peers (P = .60). Furthermore, CMPF independently predicted lower Insulin Secretion-Sensitivity Index-2 (t = -2.28, P = .02) and lower insulinogenic index/HOMA-IR (t = -2.22, P = .03) in women with GDM but not in the non-GDM group (both P = .93). Neither HPL nor prolactin was significantly associated with AUCglucose, β-cell function, or insulin sensitivity.
Conclusion:
CMPF is a potential circulating determinant of β-cell dysfunction and hyperglycemia in women with GDM.
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