title: TNFα dynamics during the oral glucose tolerance test vary according to the level of insulin resistance in pregnant women.
abstract: BACKGROUND
  TNFα is suspected to play a role in inflammation and insulin resistance leading to higher risk of metabolic impairment. Controversies exist concerning the role of TNFα in gestational insulin resistance. We investigated the interrelations between TNFα and insulin resistance in a large population-based cohort of pregnant women.
  
  
  METHODS
  Women (n = 756) were followed prospectively at 5-16 weeks and 24-28 weeks of pregnancy. Anthropometric measures and blood samples were collected at both visits. A 75-g oral glucose tolerance test (OGTT) was conducted at the second trimester to assess insulin sensitivity status (homeostasis model of assessment of insulin resistance and Matsuda index). TNFα was measured at the first trimester (nonfasting) and at each time point of the OGTT.
  
  
  RESULTS
  Participants were 28.4 ± 4.4 years old and had a mean body mass index of 25.5 ± 5.5 kg/m(2) at first trimester. Median TNFα levels were 1.56 (interquartile range, 1.18-2.06) pg/mL at first trimester and 1.61 (interquartile range, 1.12-2.13) pg/mL at second trimester (1 h after glucose load). At second trimester, higher TNFα levels were associated with higher insulin resistance index levels (r = 0.37 and -0.30 for homeostasis model of assessment of insulin resistance and Matsuda index, respectively; P < .0001), even after adjustment for age, body mass index, triglycerides, and adiponectin. Women with higher insulin resistance showed a continuing decrease in TNFα levels during the OGTT, whereas women who were more insulin sensitive showed an increase in TNFα at hour 1 and a decrease at hour 2 of the test.
  
  
  CONCLUSIONS
  Higher insulin resistance is associated with higher levels of circulating TNFα at first and second trimesters of pregnancy. TNFα level dynamics during an OGTT at second trimester vary according to insulin-resistance state.
authors: Department of Medicine (L.G., M.L. M.-C.B., J.-L.A. P.P., M.-F.H.), Université de Sherbrooke, Québec, Canada J1H 5N4; Centre de Recherché Clinique Étienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke (M.D., J.Mo., J.Mé., J.-L.A., M.-F.H.), Sherbrooke, Québec, Canada J1H 5N4; Department of Population Medicine (M.-F.H.), Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts 02215; and Massachusetts General Hospital (M.-F.H.), Boston, Massachusetts 02114.
authors: Laetitia
authors: L
authors: Guillemette
authors: Marilyn
authors: M
authors: Lacroix
authors: Marie-Claude
authors: MC
authors: Battista
authors: Myriam
authors: M
authors: Doyon
authors: Julie
authors: J
authors: Moreau
authors: Julie
authors: J
authors: Ménard
authors: Jean-Luc
authors: JL
authors: Ardilouze
authors: Patrice
authors: P
authors: Perron
authors: Marie-France
authors: MF
authors: Hivert
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014409:Tumor Necrosis Factor-alpha