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-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

β cell function;Insulin sensitivity;Adverse pregnancy outcomes

Shen Yun;Zheng Yanwei;Su Yingying;Jiang Susu;Ma Xiaojing;Hu Jiangshan;Li Changbin;Huang Yajuan;Teng Yincheng;Bao Yuqian;Tao Minfang;Zhou Jian

Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China;Department of Gynecology and Obstetrics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China;Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China

中华医学杂志（英文版）

[1]Shen Yun;Zheng Yanwei;Su Yingying;Jiang Susu;Ma Xiaojing;Hu Jiangshan;Li Changbin;Huang Yajuan;Teng Yincheng;Bao Yuqian;Tao Minfang;Zhou Jian-.Insulin sensitivity, β cell function, and adverse pregnancy outcomes in women with gestational diabetes)[J].中华医学杂志（英文版）,2022(21):2541-2546

Insulin,sensitivity,cell,adverse,pregnancy,outcomes,women,gestational,diabetes,Background,potential,impact,insulin,mellitus,GDM,remains,uncertain,We,aimed,association,between,dysfunction,resistance,composite,Methods,This,observational,study,included,diagnosed,during,Quantitative,metrics,were,calculated,using,traditional,equations,risk,was,investigated,multivariable,adjusted,logistic,regression,models,Results,Multivariable,odds,ratios,ORs,across,quartiles,homeostatic,assessment,HOMA,respectively,trend,When,considered,continuous,confidence,interval,each,unit,increase,However,other,quantitative,not,associated,Conclusions,demonstrated,significant,have,provided,additional,evidence,early,identification,besides,glycemic,values,Adverse

0.382112