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首页> 外文期刊>Journal of women’s health >The lipid accumulation product for the early prediction of gestational insulin resistance and glucose dysregulation
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The lipid accumulation product for the early prediction of gestational insulin resistance and glucose dysregulation

机译：脂质积累产物可早期预测妊娠胰岛素抵抗和葡萄糖异常

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Background: Recent insights linking insulin resistance and lipid overaccumulation suggest a novel approach for the early identification of women who may soon experience glucose dysregulation. Among women without a history of gestational diabetes, we tested the association between the lipid accumulation product (LAP) obtained in early pregnancy and glucose dysregulation or insulin resistance in the second trimester. Methods: A total of 180 white pregnant women of French-Canadian origin were included in this study. At 11-14 weeks' gestation, fasting insulin, glucose, C-peptide concentrations, and estimated insulin resistance (HOMA-IR) were obtained. The waist circumference (WC) and fasting triglycerides (TG) were measured to calculate LAP as (WC[cm] - 58)×TG[mmol/L]. At 24-28 weeks' gestation, glucose was measured 2 hours after a 75-g oral glucose challenge and other fasting variables were repeated. Results: Among the nulliparous women tested at the end of the second trimester, fasting insulin, C-peptide, insulin resistance (HOMA-IR index), fasting glucose, and 2-hour glucose progressively increased (p≤0.002) according to their first-trimester LAP tertiles. Similar results were observed in parous women except for the glucose variables. The first-trimester LAP tended to show a stronger correlation to the second-trimester HOMA-IR index (r=0.56) than fasting triglyceride levels alone (r=0.40) or waist circumference alone (r=0.44) among nulliparous women. Similar associations were observed for parous women. Adjustment for body mass index weakened these associations, especially among parous women. Conclusions: An increased value of LAP at the beginning of a pregnancy could be associated with an increased risk of insulin resistance or hyperglycemia later in gestation.
机译：背景：有关胰岛素抵抗和脂质过度积聚的最新见解为早期识别可能很快经历葡萄糖异常的女性提供了一种新方法。在没有妊娠糖尿病史的女性中，我们测试了妊娠早期获得的脂质蓄积产物（LAP）与妊娠中期的葡萄糖失调或胰岛素抵抗之间的关系。方法：本研究共纳入180名法国-加拿大裔白人孕妇。在妊娠11-14周时，获得了空腹胰岛素，葡萄糖，C肽浓度和估计的胰岛素抵抗（HOMA-IR）。测量腰围（WC）和禁食甘油三酸酯（TG）以计算LAP为（WC [cm]-58）×TG [mmol / L]。妊娠24-28周时，口服75克葡萄糖激发2小时后测量葡萄糖，并重复其他禁食变量。结果：在中期妊娠末期进行测试的未生育妇女中，空腹胰岛素，C肽，胰岛素抵抗（HOMA-IR指数），空腹血糖和2小时血糖逐渐升高（p≤0.002） -孕期LAP三分位数。除葡萄糖变量外，在同卵妇女中观察到相似的结果。与未进食妇女中单独的禁食甘油三酸酯水平（r = 0.40）或单独的腰围（r = 0.44）相比，孕早期的LAP倾向于显示与孕中期的HOMA-IR指数（r = 0.56）更相关。产后妇女也有类似的关联。体重指数的调整削弱了这些关联，尤其是在同居妇女中。结论：妊娠开始时LAP值升高可能与妊娠后期胰岛素抵抗或高血糖的风险增加有关。

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