Adipokines and β-cell dysfunction in normoglycemic women with previous gestational diabetes mellitus

INTRODUCTION An increased risk of developing type 2 diabetes in women with a history of gestational diabetes mellitus(gestational diabetes mellitus – GDM) may be associated with increased insulin resistance and subclinical inflammation. However, approximately half of women with previous GDM (pGDM) do not develop diabetes. These women were the population of focus in the present study.

OBJECTIVES The aim of the study was to assess β-cell function, insulin resistance, and the levels of pro- and anti inflammatory adipokines in normoglycemic women with pGDM.

PATIENTS AND METHODS A study group included 199 women with pGDM; the mean time after delivery was 7.4 years. A control group included 50 women without pGDM. All patients underwent an oral glucose tolerance test (OGTT) with the assessment of glycemia and insulinemia, β-cell function (HOMA-%β), and insulin resistance (HOMA-IR), as well as the levels of soluble tumor necrosis factor α receptor (sTNF-α-R2), interleukin 6 (IL-6), adiponectin, and visfatin.

RESULTS Normal glucose tolerance was found in 113 women with pGDM (56.8%; the NGT-GDM[+] group) and in 44 control subjects (88.0%). In comparison with controls, the NGT-GDM[+] group had significantly higher glycemia in the OGTT and significantly lower HOMA-%β values, with comparable HOMA-IR and body mass index values. The NGT-GDM(+) group was shown to have significantly higher levels of sTNF-α-R2 and IL-6, with similar adiponectin and visfatin levels.

CONCLUSIONS Normoglycemic women with a history of GDM are characterized by concomitant disturbances in insulin secretion and subclinical inflammation, with normal body weight and insulin sensitivity. It is not known whether these disturbances were present before a GDM-complicated pregnancy or whether they were induced by pregnancy.