Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Scientific Research, Hainan Women and Children's Medical Center, Haikou, China.
J Diabetes Investig. 2021 Sep;12(9):1723-1731. doi: 10.1111/jdi.13517. Epub 2021 Mar 17.
AIMS/INTRODUCTION: The association between plasma irisin and glucose levels in the general population is controversial, and few studies have longitudinally detected this correlation. We aimed to examine whether irisin in pregnancy was associated with postpartum glucose levels among Chinese women and explore the modifiable factors.
We carried out a prospective cohort study in Guangzhou, China, during 2017 and 2018, and 453 pregnant women (20-28 weeks) were enrolled. Plasma irisin levels in pregnancy were tested. At 6-8 weeks after delivery, 93 women with gestational diabetes mellitus (GDM) underwent a 75-g oral glucose tolerance test, and the other 360 women had a fasting blood glucose (FBG) test. Multivariable linear, quantile and logistic regressions were carried out.
The mean plasma irisin in mid-pregnancy was 13.73 ng/mL. We observed a significantly negative association between mid-pregnancy irisin and postpartum FBG (β: -0.056 ± 0.024). However, quantile regression showed the association was only significant in high percentiles of FBG levels (P to P ), and the magnitude showed an increasing trend. Higher baseline irisin was also associated with a lower risk of postpartum impaired fasting glucose (relative risk 0.563, 95% confidence interval 0.384-0.825). Furthermore, we found significant interactions between irisin and predominant breast-feeding on FBG and impaired fasting glucose (both P < 0.05). In women with GDM, baseline irisin was non-significantly associated with postpartum postprandial 2-h glucose levels (β: -0.305 ± 0.160, P = 0.061).
Plasma irisin levels in mid-pregnancy were negatively associated with FBG levels and impaired fasting glucose at 6-8 weeks postpartum among Chinese women, and stronger associations were observed in women with higher FBG values. Furthermore, breast-feeding might modify this relationship.
目的/引言：血浆鸢尾素与普通人群血糖水平之间的关系存在争议，很少有研究对此相关性进行纵向检测。我们旨在研究妊娠期间的鸢尾素是否与中国女性产后血糖水平相关，并探讨可改变的因素。
我们在中国广州进行了一项前瞻性队列研究，在 2017 年至 2018 年期间纳入了 453 名（20-28 周）孕妇。检测妊娠期间的血浆鸢尾素水平。产后 6-8 周，93 名患有妊娠糖尿病（GDM）的女性进行了 75g 口服葡萄糖耐量试验，其余 360 名女性进行了空腹血糖（FBG）检测。采用多变量线性、分位数和逻辑回归进行分析。
妊娠中期的平均血浆鸢尾素为 13.73ng/mL。我们观察到妊娠中期鸢尾素与产后 FBG 呈显著负相关（β：-0.056±0.024）。然而，分位数回归显示，这种相关性仅在 FBG 水平的高分位数中具有统计学意义（P 至 P ），且呈递增趋势。较高的基线鸢尾素也与产后空腹血糖受损的风险降低相关（相对风险 0.563，95%置信区间 0.384-0.825）。此外，我们发现鸢尾素与主要母乳喂养之间存在显著的交互作用，对 FBG 和空腹血糖受损均有影响（均 P<0.05）。在患有 GDM 的女性中，基线鸢尾素与产后 2 小时餐后血糖水平无显著相关性（β：-0.305±0.160，P=0.061）。
中国女性妊娠中期的血浆鸢尾素水平与产后 6-8 周的 FBG 水平和空腹血糖受损呈负相关，在 FBG 值较高的女性中相关性更强。此外，母乳喂养可能会改变这种关系。
