title: Erythropoietin and glucose homeostasis in women at varying degrees of future diabetic risk.
abstract: OBJECTIVE
  Recently, there has been considerable interest in the potential anti-diabetic effects of erythropoietin in animal models. It is not known, however, whether endogenous erythropoietin is associated with glucose regulation in humans.
  
  
  METHODS
  We evaluated the longitudinal relationship between endogenous erythropoietin at 3-months postpartum and glucose homeostasis at 12-months postpartum in a cohort of 229 women with varying degrees of glucose intolerance in their recent pregnancy, a model of the early natural history of pre-diabetes/diabetes. The women reflected the full spectrum of glucose tolerance in pregnancy from normal (n=63) to mildly abnormal (n=65) to gestational impaired glucose tolerance (n=46) to gestational diabetes (n=55), and hence a broad range of future diabetic risk.
  
  
  RESULTS
  At 3-months postpartum, there was no difference in serum erythropoietin between these 4 groups (p=0.22). After covariate adjustment, erythropoietin was not associated with beta-cell function, insulin sensitivity, or glycemia at either 3- or 12-months postpartum. On multiple linear regression analyses, however, erythropoietin at 3-months emerged as an independent predictor of both systolic (beta=0.51326, p=0.003) and diastolic blood pressure (beta=0.3321, p=0.01) at 12-months.
  
  
  CONCLUSIONS
  Endogenous erythropoietin is not associated with glucose homeostasis early in the natural history of metabolic disease, but may be relevant to vascular health.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Reema
authors.initials: R
authors.lastname: Shah
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Chang
authors.initials: C
authors.lastname: Ye
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada.
authors.forename: Minna
authors.initials: M
authors.lastname: Woo
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto Ontario, Canada.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hanley
authors.affiliation: Division of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Mathew
authors.initials: M
authors.lastname: Sermer
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada. Electronic address: rretnakaran@mtsinai.on.ca.
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D004921:Erythropoietin / Q000097:blood / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test / Q000379:methods; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D015994:Incidence; D050417:Insulin-Secreting Cells / Q000502:physiology; D016014:Linear Models; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D049590:Postpartum Period; D011236:Prediabetic State / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D004921:Erythropoietin
keywords: Beta-cell function; Blood pressure; Erythropoietin; Gestational diabetes; Type 2 diabetes