Differences in insulin sensitivity in pregnant women with overweight and gestational diabetes mellitus.
OBJECTIVE
The purpose of the present study was to investigate changes in insulin sensitivity using homeostasis model assessment (HOMA) and the quantitative insulin sensitivity check index (QUICKI) in normal-weight and overweight women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM) during pregnancy.


METHODS
Ninety-two pregnant women in the first trimester, 202 in the second trimester and 154 in the third trimester were enrolled in this study. Fasting plasma glucose and insulin concentrations were measured in all women in the first, second and third trimesters. HOMA indices (insulin resistance, HOMA-IR and beta-cell function, HOMA-beta) and QUICKI were calculated from fasting glucose and insulin concentrations.


RESULTS
HOMA-IR values in overweight women with NGT and in women with GDM were significantly (p < 0.01) higher than those in normal-weight women with NGT. HOMA-IR in women with GDM increased significantly (p < 0.05) during pregnancy, but HOMA-IR values in normal-weight and overweight women with NGT did not change significantly with advance of gestation. QUICKI values in overweight women with NGT and in women with GDM were also significantly (p < 0.01) lower than those in normal-weight women with NGT, and QUICKI in women with GDM decreased significantly (p < 0.05) during pregnancy. HOMA-beta in normal-weight women with NGT increased significantly (p < 0.01) during pregnancy.


CONCLUSIONS
We showed that insulin sensitivities determined by using HOMA-IR and QUICKI in overweight women with NGT and women with GDM were lower than those in normal-weight women with NGT, and that insulin sensitivity in women with GDM declined with advance of gestation.
Endo
Satoko
S
Departments of Obstetrics and Gynecology, The University of Tokushima School of Medicine, Tokushima, Japan.
Maeda
Kazuhisa
K
Suto
Masanori
M
Kaji
Takashi
T
Morine
Mikio
M
Kinoshita
Toshiko
T
Yasui
Toshiyuki
T
Irahara
Minoru
M
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005215:Fasting; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*
D001786:Blood Glucose; D007328:Insulin