Ethnic differences in BMI, subcutaneous fat, and serum leptin levels during and after pregnancy and risk of gestational diabetes.
OBJECTIVE
To explore the differences between Europeans and South Asians in BMI, subcutaneous fat, and serum leptin (s-leptin) levels during and after pregnancy and their relationship with gestational diabetes (GDM).


METHODS
Multi-ethnic population-based cohort study, whereof 353 Europeans (93.1% of the included) and 190 South Asians (95.0% of the included).


METHODS
S-leptin, BMI, and subcutaneous fat (sum of triceps, subscapular, and suprailiac skinfolds) were measured at 14 and 28 weeks of gestation, and 14 weeks after delivery. GDM was diagnosed with the WHO criteria 2013.


RESULTS
South Asians had similar thickness of the triceps and suprailiac skinfolds, thicker subscapular skinfold, and higher s-leptin than Europeans in early pregnancy, despite lower BMI. South Asians retained more subcutaneous fat (mean (95% CI) 10.0 (7.4-12.7) mm vs 3.8 (1.9-5.8) mm) and BMI (1.5 (1.2-1.8) kg/m(2) vs 0.1 (-0.1 to 0.3) kg/m(2)) than Europeans 14 weeks after delivery and s-leptin decreased less in South Asians than Europeans (-0.13 (-0.27 to -0.00) μg/l vs -0.47 (-0.57 to -0.37) μg/l, P<0.001 for all). The prevalence of GDM was 23.8% (n=84) in Europeans and 42.6% (n=81) in South Asians. BMI, subcutaneous fat, and s-leptin were all positively associated with GDM, also after adjustment for covariates.


CONCLUSIONS
The relatively high amounts of subcutaneous fat and s-leptin in South Asians in early pregnancy contributed to their increased risk of GDM. South Asians retained more weight and subcutaneous fat after delivery, potentially increasing their risk of adiposity and GDM in future pregnancies.
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway christine.sommer@medisin.uio.no.
Christine
C
Sommer
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway.
Anne K
AK
Jenum
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway.
Christin W
CW
Waage
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway.
Kjersti
K
Mørkrid
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway.
Line
L
Sletner
Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway.
Kåre I
KI
Birkeland
D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000208:ethnology*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D009664:Norway / Q000208:ethnology; D010154:Pakistan / Q000208:ethnology; D049590:Postpartum Period / Q000208:ethnology*; D011247:Pregnancy / Q000208:ethnology*; D012306:Risk; D013188:Sri Lanka / Q000208:ethnology; D050151:Subcutaneous Fat
D020738:Leptin