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Maternal serum prolactin associated with postpartum prediabetes, diabetes risk
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Higher maternal serum prolactin in pregnancy is associated with improved pancreatic beta-cell function and lower risk for prediabetes or type 2 diabetes 3 months postpartum, recent study findings show.
“The measurement of serum prolactin in pregnancy may identify those women who are the highest risk for postpartum progression to prediabetes/diabetes,” Ravi Retnakaran, MD, MSc, FRCPC, an endocrinologist and clinician-scientist at the Leadership Sinai Centre for Diabetes and Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, and associate professor, division of endocrinology, University of Toronto, told Endocrine Today. “As such, it might provide an approach for identifying those women in whom it is most important to ensure completion of the postpartum oral glucose tolerance test that is recommended in the first 6 months following a pregnancy complicated by gestational diabetes.”
Ravi Retnakaran
Retnakaran and colleagues from Mount Sinai Hospital and the University of Toronto analyzed data from 367 pregnant women who completed a 3-hour 100-g oral glucose tolerance test and underwent measurement of fasting serum prolactin, human placental lactogen (HPL) and 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) in the late second or early third trimester. Participants returned at 3 months postpartum for a 2-hour, 75-g OGTT.
At 3 months postpartum, 301 of the women had normal glucose tolerance (72% white; mean prepregnancy BMI, 23.8 kg/m²); 60 women had prediabetes (58.3% white; mean prepregnancy BMI, 24.2 kg/m²); 6 women had type 2 diabetes (66.7% white; mean prepregnancy BMI, 25.4 kg/m²). Women with normal glucose tolerance had higher serum prolactin levels in pregnancy than women with prediabetes or type 2 diabetes (median, 93.4 ng/mL vs. 82.7 ng/mL vs. 79.2 ng/mL, respectively; P = .004). Antepartum concentrations of CMPF and HPL did not differ between groups.
In multiple linear regression analyses, researchers found that higher levels of antepartum serum prolactin independently predicted lower risk for postpartum prediabetes or type 2 diabetes (OR = 0.5; 95% CI, 0.35-0.72).
“Further study is needed to identify the underlying mechanism by which prolactin in pregnancy relates to postpartum beta-cell function, which appears to be the basis for its capacity for predicting postpartum prediabetes/diabetes,” Retnakaran said. – by Regina Schaffer
For more information:
Ravi Retnakaran, MD, MSc, FRCPC, can be reached at the Leadership Sinai Centre for Diabetes at Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 60 Murray St., 5th Floor, Mailbox 21, Toronto, Ontario M5T 3L9; email: rretnakaran@mtsinai.on.ca.
Disclosure: Retnakaran is part holder of a U.S. Provisional Patents application regarding CMPF as a biomarker for diabetes and associated methods, and reports consulting for Merck, Novo Nordisk, Sanofi and Takeda and receiving research support from Merck and Novo Nordisk unrelated to this study.
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