Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
J Clin Endocrinol Metab. 2019 May 1;104(5):1394-1403. doi: 10.1210/jc.2018-01381.
Our aim was to quantify the individual contribution of prepregnancy (PP) fat-free mass (FFM), expressed as [PP-FFM index (PP-FFMI) = FFM (kg)/height (m2)], on markers of glucose homeostasis before and during pregnancy.
Body composition was assessed in 43 women before pregnancy using air-displacement plethysmography. Blood was drawn at PP and gestational weeks ∼8 and 30. Relationships between body composition (independent) variables and glucose homeostasis (dependent) variables were assessed using adjusted correlations and simple and multiple linear regression analyses.
PP-FFMI was the strongest predictor of plasma insulin concentration [squared partial correlation (Pr2) = 17, P = 0.007] and homeostasis model assessment of insulin resistance (HOMA2-IR) (Pr2 = 16, P = 0.010). At gestation week 30, PP-FFMI and gestational weight gain (GWG) were the strongest predictors of insulin concentration (PP-FFMI: Pr2 = 20, P = 0.010; GWG: Pr2 = 12, P = 0.052) and HOMA2-IR (PP-FFMI: Pr2 = 19, P = 0.012; GWG: Pr2 = 13, P = 0.045). After accounting for PP fat mass index (PP-FMI), PP-FFMI and GWG were independently associated with first-phase insulin response (PP-FFMI: Pr2 = 20, P = 0.009; GWG: Pr2 = 15, P = 0.025) and second-phase insulin response (PP-FFMI: Pr2 = 19, P = 0.011; GWG: Pr2 = 17, P = 0.016). PP-FMI was the strongest predictor of an oral glucose tolerance test‒derived estimated metabolic clearance rate of glucose (PP-FMI: Pr2 = 14, P = 0.037) and estimated insulin sensitivity index (PP-FMI: Pr2 = 13, P = 0.047).
PP-FFMI was a predictor of markers of glucose homeostasis before and during pregnancy. Studies assessing the effect of skeletal muscle quality on metabolic regulation during pregnancy are warranted.
本研究旨在定量评估孕前（PP）去脂体重（FFM）[PP-FFM 指数（PP-FFMI）=FFM（kg）/身高（m2）]对妊娠前后糖代谢稳态标志物的个体贡献。
43 名女性在妊娠前使用空气置换体积描记法评估身体成分。在 PP 和妊娠约 8 周及 30 周时采血。使用调整后的相关性以及简单和多元线性回归分析评估身体成分（独立）变量与糖代谢稳态（依赖）变量之间的关系。
PP-FFMI 是血浆胰岛素浓度的最强预测因子[平方偏相关系数（Pr2）=17，P=0.007]和稳态模型评估的胰岛素抵抗（HOMA2-IR）（Pr2=16，P=0.010）。在妊娠 30 周时，PP-FFMI 和妊娠体重增加（GWG）是胰岛素浓度（PP-FFMI：Pr2=20，P=0.010；GWG：Pr2=12，P=0.052）和 HOMA2-IR（PP-FFMI：Pr2=19，P=0.012；GWG：Pr2=13，P=0.045）的最强预测因子。在考虑到 PP 脂肪质量指数（PP-FMI）后，PP-FFMI 和 GWG 与第一时相胰岛素反应（PP-FFMI：Pr2=20，P=0.009；GWG：Pr2=15，P=0.025）和第二时相胰岛素反应（PP-FFMI：Pr2=19，P=0.011；GWG：Pr2=17，P=0.016）独立相关。PP-FMI 是口服葡萄糖耐量试验衍生的葡萄糖估计代谢清除率（PP-FMI：Pr2=14，P=0.037）和估计胰岛素敏感性指数（PP-FMI：Pr2=13，P=0.047）的最强预测因子。
PP-FFMI 是妊娠前后糖代谢稳态标志物的预测因子。有必要开展研究评估妊娠期间骨骼肌质量对代谢调节的影响。
