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Observational Study
. 2022 Jan 18;107(2):e734-e744.
doi: 10.1210/clinem/dgab655.

Rate of Gestational Weight Gain and Glucose-Insulin Metabolism Among Hispanic Pregnant Women With Overweight and Obesity

Karen L Lindsay  1   2 , Lauren E Gyllenhammer  1   3 , Sonja Entringer  1   3   4 , Pathik D Wadhwa  3   5
Affiliations
Observational Study

Rate of Gestational Weight Gain and Glucose-Insulin Metabolism Among Hispanic Pregnant Women With Overweight and Obesity

Karen L Lindsay et al. J Clin Endocrinol Metab. .

Abstract

Context: Hispanic women are at elevated risk of gestational glucose intolerance and postpartum type 2 diabetes compared with non-Hispanic White women. Identification of potentially modifiable factors contributing to this trajectory of beta-cell dysfunction is warranted.

Objective: We aimed to determine the association between rate of gestational weight gain (rGWG) and glucose-insulin metabolism in Hispanic pregnant women with overweight and obesity.

Methods: This cross-sectional, observational study, conducted from 2018-2020 at the clinical research center at University of California, Irvine, included 33 nondiabetic Hispanic pregnant women at 28 to 30 weeks' gestation with pre-pregnancy body mass index (BMI) 25.0 to 34.9 kg/m2. Participants consumed a standardized liquid mixed meal after an overnight fast. Serial blood samples were collected at fasting and up to 2 hours postprandial. The glucose and insulin area under the curve (AUC), insulin sensitivity index (ISI) and insulin secretion sensitivity index (ISSI)-2 were computed.

Results: Average rGWG (0.36 ± 0.22 kg/week) was classified as excessive in 60% of women. While rGWG was not associated with the glucose or insulin AUC or ISI, it accounted for 13.4% of the variance in ISSI-2 after controlling for covariates (maternal age, parity, and pre-pregnancy BMI); for each 1 unit increase in rGWG, ISSI-2 decreased 2.1 units (P = 0.015).

Conclusion: Even in the absence of gestational diabetes, rGWG was inversely associated with beta-cell function in a high-risk population of Hispanic pregnant women with overweight and obesity. Beta-cell decline is an established risk factor for transition to type 2 diabetes, and these cross-sectional findings highlight rGWG as a potentially modifiable contributor to this process.

Keywords: beta-cell function; gestational weight gain; glucose-insulin metabolism; insulin sensitivity; maternal overweight/obesity; pregnancy.

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Figures

Figure 1.
Figure 1.
Median plasma glucose (A) and insulin (B) response to the standardized meal across the study population.
Figure 2.
Figure 2.
Inverse association between rate of gestational weight gain per week and beta-cell function, measured by the insulin secretion sensitivity index (ISSI)-2.
See this image and copyright information in PMC

Comment in

References

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