title: Postpartum IGF-I and IGFBP-2 levels are prospectively associated with the development of type 2 diabetes in women with previous gestational diabetes mellitus.
abstract: OBJECTIVE
  Women with previous gestational diabetes mellitus (GDM) are at greater risk of developing type 2 diabetes. In the general population, the insulin-like growth factor (IGF) system has been implicated in the development of type 2 diabetes. The aim of this study was to determine if circulating IGF-I, IGF-II, IGFBP-1 and IGFBP-2 levels 12weeks following a GDM pregnancy are associated with an increased risk of developing type 2 diabetes.
  
  
  METHODS
  IGF-I, IGF-II, IGFBP-1 and IGFBP-2 levels were measured in 98 normal glucose tolerant women, 12weeks following an index GDM pregnancy using enzyme immunoassay. Women were assessed for up to 10years for the development of overt type 2 diabetes.
  
  
  RESULTS
  Among the 98 women with previous GDM, 21 (21%) developed diabetes during the median follow-up period of 8.5years. After adjusting for age and BMI, IGF-I and IGFBP-2 were significantly associated with the development of type 2 diabetes. In a clinical model of prediction of type 2 diabetes that included age, BMI, pregnancy fasting glucose and postnatal fasting glucose, the addition of IGF-I and IGFBP-2 resulted in an improvement in the net reclassification index of 17.8%.
  
  
  CONCLUSIONS
  High postpartum IGF-I and low postpartum IGFBP-2 levels are a significant risk factor for the development of type 2 diabetes in women with a previous history of GDM. This is the first report that identifies IGF-I and IGFBP-2 as a potential biomarker for the prediction of type 2 diabetes in women with a history of GDM.
authors.affiliation: Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia; Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia. Electronic address: mlappas@unimelb.edu.au.
authors.forename: M
authors.initials: M
authors.lastname: Lappas
authors.affiliation: Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Jinks
authors.affiliation: Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Shub
authors.affiliation: Centre for Nutrition and Physical Activity Research, School of Nutrition and Exercise Sciences, Deakin University, Burwood, Australia.
authors.forename: J C
authors.initials: JC
authors.lastname: Willcox
authors.affiliation: Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
authors.forename: H M
authors.initials: HM
authors.lastname: Georgiou
authors.affiliation: Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Permezel
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D018971:Insulin-Like Growth Factor Binding Protein 2; D007334:Insulin-Like Growth Factor I
keywords: Gestational diabetes mellitus; IGF; IGFBP; Type 2 diabetes