Link between leptin, type 2 diabetes risk differs by gestational diabetes history
Click Here to Manage Email Alerts
Four body fat-related biomarkers are linked to risk for type 2 diabetes for parous women; for one of these, the association differs by gestational diabetes status, researchers found.
Among a group of women who have had children, alanine aminotransferase and visceral adipose tissue were positively associated with incident type 2 diabetes, and adiponectin was inversely associated, regardless of past gestational diabetes. Leptin was positively associated with diabetes development for women without gestational diabetes, but inversely associated for women with that history, according to data published in Obesity.
“Women who have gestational diabetes are seven times more likely to get type 2 diabetes later in life than women who had pregnancies but didn’t have gestational diabetes,” Pandora L. Wander, MD, from the VA Puget Sound Health Care System and the department of medicine at the University of Washington, Seattle, told Healio. “We don’t really understand what factors contribute to the differences in type 2 diabetes risk among women with and without a history of gestational diabetes, so we did this study to understand whether markers of body fat contribute differently to the development of type 2 diabetes in women with and without a history of gestational diabetes.”
Wander and colleagues analyzed data from 1,711 women who participated in the Diabetes Prevention Program and reported a previous live birth (mean age, 49.8 years). Researchers analyzed data on the adiposity-related biomarkers leptin, adiponectin, sex hormone-binding globulin and alanine aminotransferase for all participants and visceral and subcutaneous adipose tissue areas in the L2-L3 region and the L3-L4 region by CT for 477 of the participants.
After an average follow-up of 12.9 years, there were 871 incident type 2 diabetes cases. Researchers observed a positive association between alanine aminotransferase (P = .024), L2-L3 (P = .009) and L3-L4 visceral adipose tissue (P = .004) and type 2 diabetes. However, there was an inverse association between adiponectin concentration and type 2 diabetes (P < .001).
No association between leptin concentration and type 2 diabetes was observed in the full cohort. However, when modeled according to gestational diabetes status, researchers found that a 1 standard deviation increase in leptin concentration was positively associated with type 2 diabetes risk among women without gestational diabetes (HR = 1.126; P = .016) and inversely associated among women with gestational diabetes (HR = 0.776; P = .013).
“We were surprised that the relationship between leptin and incident diabetes was different in women with and without gestational diabetes. Our study can’t explain why we see this different relationship, but we can speculate about it,” Wander said. “Total body fat mass and leptin levels are closely related, and higher body fat — especially abdominal fat — is a risk factor for type 2 diabetes. But leptin levels are also stimulated by insulin, and women with a history of gestational diabetes often have a more limited ability to secrete insulin than women without a history of gestational diabetes who are otherwise similar. So, one factor that may be contributing to the different relationship ... may be that once the ability to secrete insulin gets low enough, it doesn’t match up with body fat quite as well.”
Collapse
Click Here to Manage Email Alerts