J. Gómez de Tejada‑Romero1,2· P. Saavedra‑Santana3  · F. de la Rosa‑Fernández1  · N. Suárez‑Ramírez1  ·Martín‑Martínez1,4· F. Martín del Rosario1  · M. Sosa‑Henríquez1,5

Received: 1 April 2022 / Accepted: 14 June 2022 / Published online: 4 July 2022 © The Author(s) 2022

Abstract

Aims To see the effects of obesity on risk fracture, bone density (BMD), and vitamin D levels in a group of postmenopausal women, and consider how comorbid type 2 diabetes mellitus (T2DM) modifies them.

Methods 679 postmenopausal women were grouped into obese and non-obese. Obese women were grouped into those with T2DM and those without. 25(OH)-vitamin D, PTH and BMD were measured, and prevalent fragility fractures were gathered.

Results Obese women had higher prevalence of T2DM, than non-obese women. Levels of 25(OH)-vitamin D were lower and those of PTH higher in obese women, BMD values were higher in obese women. Diabetic-obese women had a higher prevalence of non-vertebral fractures than non-diabetic-obese. Multivariate logistic regression model showed association of fragility fractures with age, total hip BMD, BMI and T2DM. Obese women have higher BMD and lower 25(OH)-vitamin D values (and higher PTH) than non-obese, without diabetes.

Conclusions T2DM confers an increased risk of non-vertebral fractures in postmenopausal obese women.

Keywords Obesity · Diabetes Mellitus type 2 · Vitamin D · Fragility fractures · Osteoporosis

Managed by Massimo Porta. M. Sosa-Henríquez 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Research Group On Osteoporosis and Mineral Metabolism, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

2 Department of Medicine, University of Seville, Seville, Spain

3 Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

4 Gynecology and Obstetrics Service, Maternal-Infant Insular University Hospital Complex, Las Palmas de Gran Canaria, Spain

5 Bone Metabolic Unit, Maternal-Infant Insular University Hospital Complex, Las Palmas de Gran Canaria, Spain

Zhuofan Yang1  · Zhuyu Li1  · Yunjiu Cheng2  · Peisong Chen3  · Dongyu Wang1  · Haitian Chen1  · Wei Chen1  · Zilian Wang1

Zhuofan Yang, Zhuyu Li, Yunjiu Cheng have contributed equally to this work.

Zilian Wang 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Rd II, Guangzhou 510080, China

2 Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

3 Department of Clinical Laboratory, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

Received: 19 February 2022 / Accepted: 12 May 2022 / Published online: 5 July 2022 © The Author(s) 2022

Abstract

Aims To assess lipid trajectories throughout pregnancy in relation to early postpartum glucose intolerance in women with gestational diabetes mellitus (GDM).

Methods This prospective cohort study included 221 Chinese women with GDM who completed plasma lipid test in each trimester of pregnancy and oral glucose tolerance test at 6–9 weeks postdelivery between January 1, 2018 and January 8, 2020. Using the group-based trajectory modeling, total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol(HDL-c) were identifed separately as three trajectories: low, moderate, and high trajectory. The associations between lipid trajectories and early postpartum glucose intolerance were all evaluated.

Results Seventy-three participants developed postpartum glucose intolerance. For patients in low, moderate and high trajectory, the incidence of postpartum glucose intolerance was 38.4%, 34.9%, and 17.9%, respectively. GDM women with lower LDL-c trajectories presented a higher risk of postpartum glucose intolerance. The adjusted odds ratio (95% CI) for glucose intolerance was 3.14 (1.17–8.39) in low LDL-c trajectory and 2.68 (1.05–6.85) in moderate trajectory when compared with the high one. However, TC trajectory was not associated with the risk of postpartum glucose intolerance, nor were TG trajectory and HDL-c trajectory. Moreover, a significant difference of insulin sensitivity was observed in participants with different LDL-c trajectories; participants in high LDL-c trajectory had the highest insulin sensitivity, whereas the women in low LDL-c trajectory had the lowest insulin sensitivity (P=0.02).

Conclusions The high trajectory of LDL-c during pregnancy may play a protective role on postpartum glucose intolerance in women with GDM. Further studies are warranted to explore the underlying mechanism. Trial registration The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Sun Yat-sen University (reference number: [2014]No. 93). All participants provided written informed consent forms, and the ethics committee approved this consent procedure.

Keywords Lipid trajectory · Glucose intolerance · Gestational diabetes mellitus · Insulin sensitivity

This article belongs to the topical collection Pregnancyand Diabetes, managed by Antonio Secchi and Marina Scavini.

Abbreviations

GDM Gestational diabetes mellitus

GBTM Group-based trajectory modeling

TC Total cholesterol

TG Triglyceride

LDL-c Low-density lipoprotein-cholesterol

HDL-c High-density lipoprotein-cholesterol

PGDM Pregestational diabetes mellitus

OGTT Oral glucose tolerance test

FBG Fasting blood glucose

HOMA-IS Homeostasis model assessment-IS

BIC Bayesian information criterion

AvePP Average posterior probability

NODM New-onset diabetes mellitus

LDLR Low-density protein receptor

Zhuofan Yang1  · Zhuyu Li1  · Yunjiu Cheng2  · Peisong Chen3  · Dongyu Wang1  · Haitian Chen1  · Wei Chen1  · Zilian Wang1

1 Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Rd II, Guangzhou 510080, China

2 Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

3 Department of Clinical Laboratory, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Received: 19 February 2022 / Accepted: 12 May 2022 / Published online: 5 July 2022 © The Author(s) 2022

Abstract

Aims To assess lipid trajectories throughout pregnancy in relation to early postpartum glucose intolerance in women with gestational diabetes mellitus (GDM).

Methods This prospective cohort study included 221 Chinese women with GDM who completed plasma lipid test in each trimester of pregnancy and oral glucose tolerance test at 6–9 weeks postdelivery between January 1, 2018 and January 8, 2020. Using the group-based trajectory modeling, total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol(HDL-c) were identified separately as three trajectories: low, moderate, and high trajectory. The associations between lipid trajectories and early postpartum glucose intolerance were all evaluated.

Results Seventy-three participants developed postpartum glucose intolerance. For patients in low, moderate and high trajectory, the incidence of postpartum glucose intolerance was 38.4%, 34.9%, and 17.9%, respectively. GDM women with lower LDL-c trajectories presented a higher risk of postpartum glucose intolerance. The adjusted odds ratio (95% CI) for glucose intolerance was 3.14 (1.17–8.39) in low LDL-c trajectory and 2.68 (1.05–6.85) in moderate trajectory when compared with the high one. However, TC trajectory was not associated with the risk of postpartum glucose intolerance, nor were TG trajectory and HDL-c trajectory. Moreover, a significant difference of insulin sensitivity was observed in participants with different LDL-c trajectories; participants in high LDL-c trajectory had the highest insulin sensitivity, whereas the women in low LDL-c trajectory had the lowest insulin sensitivity (P=0.02).

Conclusions The high trajectory of LDL-c during pregnancy may play a protective role on postpartum glucose intolerance in women with GDM. Further studies are warranted to explore the underlying mechanism. Trial registration The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Sun Yat-sen University (reference number: [2014]No. 93). All participants provided written informed consent forms, and the ethics committee approved this consent procedure.

Keywords Lipid trajectory · Glucose intolerance · Gestational diabetes mellitus · Insulin sensitivity

      This article belongs to the topical collection Pregnancyand Diabetes, managed by Antonio Secchi and Marina Scavini.

      Zhuofan Yang, Zhuyu Li, Yunjiu Cheng have contributed equally to this work. Zilian Wang 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Abbreviations

GDM Gestational diabetes mellitus

GBTM Group-based trajectory modeling

TC Total cholesterol

TG Triglyceride

LDL-c Low-density lipoprotein-cholesterol

HDL-c High-density lipoprotein-cholesterol

PGDM Pregestational diabetes mellitus

OGTT Oral glucose tolerance test

FBG Fasting blood glucose

HOMA-IS Homeostasis model assessment-IS

BIC Bayesian information criterion

AvePP Average posterior probability

NODM New-onset diabetes mellitus

LDLR Low-density protein receptor