Soffer Marti D, James Kaitlyn E, Callahan Michael, Rosenberg Emily A, Barth William H, Powe Camille E
Harvard Medical School, Boston, MA.
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA.
J Endocr Soc. 2024 Nov 22;9(1):bvae207. doi: 10.1210/jendso/bvae207. eCollection 2024 Nov 26.
Assessments for hyperglycemia are vital to pregnancy and postpartum (PP) care, but gold-standard oral glucose tolerance tests (OGTTs) are burdensome. We examined changes in 1,5 anhydroglucitol (1,5AG) levels during gestation and PP and assessed for associations with other measures of glycemia.
Pregnant participants (n = 50) in the Study of Pregnancy Regulation of Insulin and Glucose cohort underwent OGTTs at a mean of 13 weeks ([visit 1 (V1)] and 26 weeks [visit 2 (V2)] of gestation and PP. Nonpregnant controls had a single OGTT. 1,5AG was measured using frozen plasma samples. Changes in 1,5AG across pregnancy were assessed with longitudinal mixed effects linear models. We assessed relationships between 1,5AG and glycemia at each timepoint using Spearman correlations and linear regression models. To determine the relationship of 1,5AG with breastfeeding (BF) status, stratified analyses were performed.
1,5AG decreased from V1 to V2 (β = -3.6 μg/mL, < .001) and remained low PP compared to V1 (β = -1.4 μg/mL, = .018). Comparisons between pregnant/PP and nonpregnant participants revealed lower 1,5AG values at all timepoints (V1 β = -9.9μg/mL, < .001; V2 β = -14.0 μg/mL, < .001, PP β = -11.4μg/mL, < .001). There was no association between 1,5AG and glycemia. Compared to those exclusively feeding formula, 1,5AG levels were significantly lower in exclusively BF women (β = -8.8 μg/mL, < .001) and intermediate in women feeding both breastmilk and formula (β = -6.1μg/mL, < .001), independent of glycemia.
1,5AG decreases during gestation and remains low PP. Breastfeeding is associated with lower 1,5AG levels, indicating plausible excretion into breastmilk. 1,5AG is unlikely to be useful in assessing glycemia in pregnant or PP women.
高血糖评估对孕期及产后护理至关重要，但金标准口服葡萄糖耐量试验（OGTT）较为繁琐。我们研究了孕期及产后1,5 - 脱水葡萄糖醇（1,5AG）水平的变化，并评估其与其他血糖指标的相关性。
参与胰岛素和葡萄糖孕期调节研究队列的50名孕妇在妊娠平均13周（[访视1（V1）]）和26周（[访视2（V2）]）以及产后接受OGTT。非孕对照组进行一次OGTT。使用冷冻血浆样本测量1,5AG。采用纵向混合效应线性模型评估孕期1,5AG的变化。我们使用Spearman相关性和线性回归模型评估每个时间点1,5AG与血糖之间的关系。为确定1,5AG与母乳喂养（BF）状态的关系，进行了分层分析。
1,5AG从V1到V2下降（β = -3.6μg/mL，P <.001），与V1相比产后仍保持低水平（β = -1.4μg/mL，P =.018）。孕妇/产后与非孕参与者之间的比较显示，所有时间点1,5AG值均较低（V1时β = -9.9μg/mL，P <.001；V2时β = -14.0μg/mL，P <.001，产后β = -11.4μg/mL，P <.001）。1,5AG与血糖之间无关联。与纯配方奶喂养者相比，纯母乳喂养女性的1,5AG水平显著较低（β = -8.8μg/mL，P <.001），混合喂养（母乳和配方奶）女性的1,5AG水平居中（β = -6.1μg/mL，P <.001），且不受血糖影响。
孕期1,5AG水平下降，产后仍保持低水平。母乳喂养与较低的1,5AG水平相关，表明其可能排泄到母乳中。1,5AG不太可能用于评估孕妇或产后女性的血糖情况。
