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Contribution of Insulin Resistance and β Cell Dysfunction to Gestational Diabetes Stratified for Pre-pregnant Body Mass Index

  • Reproductive Endocrinology: Original Article
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Abstract

The objective of the study was to evaluate the contribution of insulin resistance and β cell dysfunction to gestational diabetes mellitus (GDM) in Chinese women stratified by pre-pregnant body mass index (BMI). A total of 847 pregnant women were enrolled. They were divided into low BMI and high BMI groups according to the median of pre-pregnancy BMI. The homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-β), Matsuda index, and 60-min insulinogenic index (IGI60) were used to evaluate insulin resistance and β cell function. In all the participants, 150 (17.71%) were diagnosed with GDM. ROC analyses showed that in the low BMI group, the association of β cell dysfunction (IGI60 or HOMA-β) with GDM was stronger than that of insulin resistance (Matsuda index or HOMA-IR), while in the high BMI group, the association of β cell dysfunction with GDM was weaker than that of insulin resistance (all P < 0.05). Among all GDM patients, 47.33% demonstrated predominant insulin resistance (Matsuda index < 25th percentile), and 46% had predominant β cell defect (IGI60 < 25th percentile). In the low BMI group, 15.09% of GDM patients demonstrated predominant insulin resistance, and 62.26% of GDM patients had predominant β cell defect, whereas in the high BMI group, 64.95% of GDM patients demonstrated mainly insulin resistance and 36.08% of GDM patients had mainly β cell defect. In women with low BMI, β cell dysfunction is the major etiologic factor, whereas, in women with high BMI, insulin resistance is the predominant etiologic factor in the development of GDM.

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Data Availability

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding authors.

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Acknowledgements

We appreciate the support of Wei Wang at Beijing Chao-yang Hospital, Capital Medical University, for his contribution to data collection and language polishing.

Funding

Zhe Chen was supported by grants from Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease (No. Dxwl2021-01) and Capital General Practice Research Project (22QK08); Qingrong Pan was supported by grants from The Capital Health Research and Development of General Practice; Junli Lu was supported by a grant from National Key Research and Development Program of China (Project No: 2021YFC2700705). The funder had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Qingrong Pan, Yanna Yang, and Huawei Cao contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China

    Qingrong Pan, Yuanyuan Zhan & Zhe Chen

  2. Department of General Practice, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Yanna Yang & Zeyang Tian

  3. Department of Emergency, Beijing Electric Power Hospital, Capital Medical University, Beijing, China

    Yanna Yang

  4. Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Huawei Cao

  5. Department of Education, Second College of Clinical Medicine, Tianjin Medical University, Tianjin, China

    Zibo Xu

  6. Department of General Practice, Binhe Street Community Health Service Center, Pinggu District, Beijing, China

    Zeyang Tian

  7. Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China

    Zhan Li, Menghan Lu, Fang Gu, Qi Lu, Liyun Gong, Hao Liu, Yanfang Li & Junli Lu

Authors
  1. Qingrong Pan
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Contributions

QP and ZC conceived and designed the study; QP, YY, ZT, HC, ZL, ML, FG, QL, LG, HL, YL, YZ, and ZC performed the study; YY, HC, ZX, and YZ collected and analyzed the data; QP, YY, and HC wrote the paper; ZC and JL read through and corrected the article. All the authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Junli Lu or Zhe Chen.

Ethics declarations

Ethics Approval and Consent to Participate

This study was approved by the Ethics Committee of Beijing Chao-yang Hospital, Capital Medical University. The IRB approval number was 2020-ke-480. Written informed consent was provided by all participants.

Consent for Publication

All the authors contributed to the article and agreed to publish the obtained data and analysis results of the study.

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The authors declare no competing interests.

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Pan, Q., Yang, Y., Cao, H. et al. Contribution of Insulin Resistance and β Cell Dysfunction to Gestational Diabetes Stratified for Pre-pregnant Body Mass Index. Reprod. Sci. 31, 1151–1158 (2024). https://doi.org/10.1007/s43032-023-01379-6

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  • DOI: https://doi.org/10.1007/s43032-023-01379-6

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