Visceral fatness and insulin sensitivity in women with a previous history of gestational diabetes mellitus.
OBJECTIVE
The purpose of this study was to investigate the insulin sensitivity and visceral fatness in women with previous gestational diabetes mellitus (GDM), who are prone to develop type 2 diabetes.


METHODS
A 75-g oral glucose tolerance test (OGTT) performed 1 year postpartum identified 21 GAD(-) women with previous GDM and impaired glucose tolerance (GDM-IGT). Sixty age- and BMI-matched women with normal glucose tolerance (GDM-NGT) were selected by 1:3 matching to the GDM-IGT group. Another 18 women with normal glucose metabolism during a previous pregnancy and no family history of diabetes were recruited as the normal control group. Age and BMI matching was performed using a range of +/-1.0 years and +/-1.0 kg/m(2), respectively. Total body fat was measured by tetrapolar bioelectrical impedance, and visceral fat was determined using a single cut of a computed tomography scan. Insulin sensitivity was determined by the minimal model technique using the frequently sampled intravenous glucose tolerance test.


RESULTS
One year postpartum, visceral fat was greater in the GDM-IGT group than in the age- and BMI-matched GDM-NGT or normal control groups. The insulin sensitivity index was lower in the GDM-IGT group than in the GDM-NGT or normal control groups. beta-Cell function, as measured by the acute insulin response to glucose, was also lower in GDM-IGT.


CONCLUSIONS
High body fat content, especially visceral fat content, and a low insulin response to glucose seem to contribute simultaneously to the development of impaired glucose metabolism in Korean women with previous GDM.
Lim
Soo
S
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong Bundang-gu, Seongnam-city, South Korea 463-707.
Choi
Sung Hee
SH
Park
Young Joo
YJ
Park
Kyong Soo
KS
Lee
Hong Kyu
HK
Jang
Hak C
HC
Cho
Nam H
NH
Metzger
Boyd E
BE
D000273:Adipose Tissue / Q000033:anatomy & histology*; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000494:pharmacology; D007723:Korea / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D014781:Viscera / Q000033:anatomy & histology
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin