Postpartum IGF-I and IGFBP-2 levels are prospectively associated with the development of type 2 diabetes in women with previous gestational diabetes mellitus

• Published in: Diabetes & metabolism Vol. 42; no. 6; pp. 442 - 447
• Main Authors: Lappas, M, Jinks, D, Shub, A, Willcox, J.C, Georgiou, H.M, Permezel, M
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.12.2016
• Subjects: Adult; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes, Gestational - epidemiology; Endocrinology & Metabolism; Female; Gestational diabetes mellitus; Humans; IGF; IGFBP; Insulin-Like Growth Factor Binding Protein 2 - blood; Insulin-Like Growth Factor I - analysis; Internal Medicine; Pregnancy; Prospective Studies; ROC Curve; Type 2 diabetes; IGFBP; Type 2 diabetes; Gestational diabetes mellitus; IGF
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2016.06.004

Abstract Aims 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 12 weeks 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, 12 weeks following an index GDM pregnancy using enzyme immunoassay. Women were assessed for up to 10 years 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 8.5 years. 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.