title: The lipid accumulation product for the early prediction of gestational insulin resistance and glucose dysregulation.
abstract: 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 HOMAIR 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.
authors.affiliation: Department of Medicine, Universite´ de Montre´al, ECOGENE-21 and Lipid Clinic, Chicoutimi Hospital, Saguenay, Quebec, Canada. diane.brisson@ecogene21.org
authors.forename: Diane
authors.initials: D
authors.lastname: Brisson
authors.forename: Patrice
authors.initials: P
authors.lastname: Perron
authors.forename: Henry S
authors.initials: HS
authors.lastname: Kahn
authors.forename: Daniel
authors.initials: D
authors.lastname: Gaudet
authors.forename: Luigi
authors.initials: L
authors.lastname: Bouchard
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D011264:Pregnancy Trimesters / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference / Q000502:physiology*
chemical_list: D014280:Triglycerides