title: High calorie intake is associated with worsening insulin resistance and β-cell function in Hispanic women after gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess associations between dietary intake and rates of change in insulin resistance and β-cell function in Hispanic women with prior gestational diabetes mellitus (GDM).
  
  
  METHODS
  Sixty-two nondiabetic Hispanic women with pregnancies complicated by GDM completed oral and intravenous glucose tolerance tests and bioelectrical impedance measurements of body fat every 12-15 months postpartum for up to 12 years. Self-reported dietary intake was collected at all visits by structured food frequency questionnaires developed for Hispanics. Mixed-effects models were used to assess the relationship between dietary intake and rates of change in metabolic outcomes during follow-up.
  
  
  RESULTS
  The median length of follow-up from the first postpartum evaluation was 8.0 years (interquartile range 4.5-10.8 years). At baseline, women were 32 ± 5.7 years old and had a median calorie intake of 2,091 kcal/day. Over the course of follow-up, dietary intake did not change significantly. Higher baseline calorie intake was associated with a faster decline in insulin sensitivity, measured by the insulin sensitivity index (SI) (P = 0.029), and β-cell compensation, measured by the disposition index (DI) (P = 0.027), over time. These associations remained after adjustment for baseline characteristics; changes in BMI, calorie intake, levels of physical activity; and additional pregnancies during the follow-up period. The median rates were -0.06 vs. -0.02 units/year for SI and -810 vs. -692 units/year for DI for women with baseline calorie intake above versus below the cohort median.
  
  
  CONCLUSIONS
  High calorie intake is associated with a faster decline in insulin sensitivity and β-cell compensation in Hispanic women who are at high risk for type 2 diabetes, independent of adiposity.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Zhanghua
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Physiology and Biophysics, University of Southern California, Los Angeles, CA Diabetes & Obesity Research Institute, University of Southern California, Los Angeles, CA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Watanabe
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Stram
authors.affiliation: Diabetes & Obesity Research Institute, University of Southern California, Los Angeles, CA Department of Medicine, Division of Diabetes and Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchanan
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA anny.h.xiang@kp.org.
authors.forename: Anny H
authors.initials: AH
authors.lastname: Xiang
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D016640:Diabetes, Gestational / Q000208:ethnology / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D017097:Electric Impedance; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D049590:Postpartum Period / Q000208:ethnology / Q000502:physiology; D011247:Pregnancy