Soluble Leptin Receptor and Risk of Gestational Diabetes in a Multiethnic Population: A Prospective Cohort Study
Christine Sommer1, Hanne Løvdal Gulseth1, Anne Karen Jenum1
1Department of Endocrinology, Morbid Obesity and Preventive Medicine (C.S., H.L.G., K.I.B.), Oslo University Hospital, Oslo, Norway; Department of Non-Communicable Diseases (H.L.G.), Norwegian Institute of Public Health, Oslo, Norway; Department of General Practice (A.K.J.), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Child and Adolescents Medicine (L.S.), Akershus University Hospital, Lørenskog, Norway; Hormone Laboratory (P.M.T.), Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine (K.I.B.), Faculty of Medicine, University of Oslo, Oslo, Norway.
Context:
Soluble leptin receptor (sOb-R), a potential marker of leptin resistance, is inversely associated with risk of type 2 diabetes, independently of leptin concentrations. We have previously shown that ethnic difference in leptin concentration may partly explain the increased risk of gestational diabetes (GDM) in South Asians.
Objective:
Our objective was to investigate whether sOb-R concentrations are associated with risk of GDM, whether concentrations of sOb-R differ across ethnic groups, and whether ethnic differences in sOb-R explain the ethnic differences in GDM risk.
Design And Setting:
The STORK Groruddalen study; a prospective cohort study of pregnant women living in Oslo, Norway, between May 2008 and May 2010.
Participants:
Of the total sample (n = 823), 680 (47.1% Europeans) had sOb-R measured in pregnancy week 15 and an oral glucose tolerance test performed in week 28.
Main Outcome Measure:
GDM was diagnosed according to World Health Organization 2013 criteria.
Results:
sOb-R was inversely associated with GDM (odds ratio, 0.76 [95% confidence interval, 0.69-0.83] per ng/ml increase in sOb-R, P < .001) in crude analysis. The association was attenuated after adjustments for covariates and leptin (0.85 [0.77-0.95], P = .004). Compared to women with sOb-R higher than 5 ng/ml, the odds ratio of GDM was 0.29(0.11-0.78; P = .014) among women with sOb-R greater than 10 ng/ml and 0.59 (0.37-0.94; P = .026) among women with sOb-R 5-10 ng/ml, in adjusted analysis. sOb-R levels did not differ across ethnic groups, and sOb-R did not explain ethnic differences in GDM risk.
Conclusions:
There was an independent, inverse association between sOb-R and GDM, with the lowest risk of GDM observed among higher sOb-R concentrations.
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