Insulin sensitivity, β cell function, and adverse pregnancy outcomes in women with gestational diabetes

作者：Yun Shen, Yanwei Zheng, Yingying Su, Susu Jiang, Xiaojing Ma, Jiangshan Hu, Changbin Li, Yajuan Huang, Yincheng Teng, Yuqian Bao, Minfang Tao, Jian Zhou · 发表于：Chinese Medical Journal · 年份：2022 · DOI：10.1097/cm9.0000000000002337 · 被引用次数：10 · 研究领域：Gestational Diabetes Research and Management、Pancreatic function and diabetes、Diabetes and associated disorders

BACKGROUND: The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes. METHODS: This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models. RESULTS: Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively (P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively (P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1...