RT Journal Article
SR Electronic
T1 Insulin-Like Growth Factor Axis and Gestational Diabetes Mellitus: A Longitudinal Study in a Multiracial Cohort
JF Diabetes
JO Diabetes
FD American Diabetes Association
SP 3495
OP 3504
DO 10.2337/db16-0514
VO 65
IS 11
A1 Zhu, Yeyi
A1 Mendola, Pauline
A1 Albert, Paul S.
A1 Bao, Wei
A1 Hinkle, Stefanie N.
A1 Tsai, Michael Y.
A1 Zhang, Cuilin
YR 2016
UL http://diabetes.diabetesjournals.org/content/65/11/3495.abstract
AB The insulin-like growth factor (IGF) axis may be implicated in glucose homeostasis, but its longitudinal profile across gestation in relation to the development of gestational diabetes mellitus (GDM) is largely unknown. We prospectively investigated IGF axis biomarkers in early-to-midpregnancy in relation to subsequent GDM risk in a case-control study of 107 case subjects with GDM and 214 control subjects without GDM, with blood sample collection at gestational weeks 10–14, 15–26, 23–31, and 33–39. Conditional logistic regression was used, adjusting for major risk factors including prepregnancy BMI. Plasma IGF-I and IGF binding protein 3 (IGFBP-3) concentrations and molar ratio of IGF-I to IGFBP-3 increased, whereas IGFBP-2 decreased throughout pregnancy. At gestational weeks 10–14, both IGF-I and IGF-I/IGFBP-3 were positively associated with GDM risk; adjusted odds ratio (OR) comparing the highest versus lowest quartile (ORQ4-Q1) was 2.93 (95% CI 1.18, 7.30) for IGF-I and 3.31 (1.10, 9.98) for IGF-I/IGFBP-3. In contrast, higher IGFBP-2 levels were related to a substantially lower risk of GDM (ORQ4-Q1 0.04 [0.01, 0.06]). Similar results were observed at gestational weeks 15–26. In sum, the IGF axis, IGFBP-2 in particular, may be implicated in the pathogenesis of GDM, with significant associations and incremental predictive value detected as early as gestational weeks 10–14, ∼10–18 weeks earlier before GDM is typically screened for.