title: Maternal Glucose and Fatty Acid Kinetics and Infant Birth Weight in Obese Women With Type 2 Diabetes.
abstract: The objectives of this study were 1) to describe maternal glucose and lipid kinetics and 2) to examine the relationships with infant birth weight in obese women with pregestational type 2 diabetes during late pregnancy. Using stable isotope tracer methodology and mass spectrometry, maternal glucose and lipid kinetic rates during the basal condition were compared in three groups: lean women without diabetes (Lean, n = 25), obese women without diabetes (OB, n = 26), and obese women with pregestational type 2 diabetes (OB+DM, n = 28; total n = 79). Glucose and lipid kinetics during hyperinsulinemia were also measured in a subset of participants (n = 56). Relationships between maternal glucose and lipid kinetics during both conditions and infant birth weight were examined. Maternal endogenous glucose production (EGP) rate was higher in OB+DM than OB and Lean during hyperinsulinemia. Maternal insulin value at 50% palmitate Ra suppression (IC50) for palmitate suppression with insulinemia was higher in OB+DM than OB and Lean. Maternal EGP per unit insulin and plasma free fatty acid concentration during hyperinsulinemia most strongly predicted infant birth weight. Our findings suggest maternal fatty acid and glucose kinetics are altered during late pregnancy and might suggest a mechanism for higher birth weight in obese women with pregestational diabetes.
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO tcade@wustl.edu.
authors: W Todd
authors: WT
authors: Cade
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Rachel A
authors: RA
authors: Tinius
authors: Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Dominic N
authors: DN
authors: Reeds
authors: Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Bruce W
authors: BW
authors: Patterson
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Alison G
authors: AG
authors: Cahill
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007700:Kinetics; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism; D011262:Pregnancy Trimester, Second / Q000378:metabolism; D011263:Pregnancy Trimester, Third / Q000378:metabolism; D011254:Pregnancy in Diabetics / Q000378:metabolism; D011297:Prenatal Exposure Delayed Effects / Q000378:metabolism; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005227:Fatty Acids