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Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus.

Publication ,  Journal Article
Wolf, M; Sauk, J; Shah, A; Vossen Smirnakis, K; Jimenez-Kimble, R; Ecker, JL; Thadhani, R
Published in: Diabetes Care
January 2004

OBJECTIVE: Increased leukocyte count is a marker of inflammation that has been associated with the development of type 2 diabetes in prospective studies. Although gestational diabetes mellitus (GDM) and type 2 diabetes share certain pathophysiological mechanisms, few studies have examined inflammation and risk of GDM. RESEARCH DESIGN AND METHODS: We prospectively examined routine leukocyte counts collected at the first prenatal visit in a cohort of 2,753 nulliparous euglycemic women, 98 (3.6%) of whom were later diagnosed with GDM. Subjects were divided into quartiles of leukocyte count, and the results of third-trimester glucose screening tests and the incidence of GDM among these quartiles were compared. Logistic regression was used to calculate univariate and multivariable-adjusted relative risks (RRs) of GDM according to leukocyte quartiles. RESULTS: Leukocyte counts were increased among women who subsequently developed GDM compared with those who remained free of GDM (10.5 +/- 2.2 vs. 9.2 +/- 2.2 x 10(3) cells/ml; P < 0.01). There was a linear increase in postloading mean glucose levels (P for trend <0.01), the area under the glucose tolerance test curves (P for trend <0.01), and the incidence of GDM (quartile 1, 1.1; quartile 2, 2.5; quartile 3, 4.2; and quartile 4, 6.4%; P for trend <0.01) with increasing leukocyte quartiles. In the multivariable-adjusted analysis, the linear trend in the RR of GDM with increasing leukocyte quartiles remained statistically significant (quartile 1, reference; quartile 2, RR 2.3 [95% CI 0.9-5.7]; quartile 3, 3.3 [1.4-7.8]; quartile 4, 4.9 [2.1-11.2]; P for trend <0.01). CONCLUSIONS: Increased leukocyte count early in pregnancy is independently and linearly associated with the results of GDM screening tests and the risk of GDM. Although overlap in the leukocyte count distributions precludes it from being a clinically useful biomarker, these data suggest that inflammation is associated with the development of GDM and may be another pathophysiological link between GDM and future type 2 diabetes.

Duke Scholars

Published In

Diabetes Care

DOI

ISSN

0149-5992

Publication Date

January 2004

Volume

27

Issue

1

Start / End Page

21 / 27

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pregnancy
  • Inflammation
  • Infant, Newborn
  • Humans
  • Glucose Intolerance
  • Gestational Age
  • Female
  • Endocrinology & Metabolism
  • Diabetes, Gestational
 

Citation

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Wolf, M., Sauk, J., Shah, A., Vossen Smirnakis, K., Jimenez-Kimble, R., Ecker, J. L., & Thadhani, R. (2004). Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus. Diabetes Care, 27(1), 21–27. https://doi.org/10.2337/diacare.27.1.21
Wolf, Myles, Jenny Sauk, Anand Shah, Karen Vossen Smirnakis, Ricardo Jimenez-Kimble, Jeffrey L. Ecker, and Ravi Thadhani. “Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus.Diabetes Care 27, no. 1 (January 2004): 21–27. https://doi.org/10.2337/diacare.27.1.21.
Wolf M, Sauk J, Shah A, Vossen Smirnakis K, Jimenez-Kimble R, Ecker JL, et al. Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus. Diabetes Care. 2004 Jan;27(1):21–7.
Wolf, Myles, et al. “Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus.Diabetes Care, vol. 27, no. 1, Jan. 2004, pp. 21–27. Pubmed, doi:10.2337/diacare.27.1.21.
Wolf M, Sauk J, Shah A, Vossen Smirnakis K, Jimenez-Kimble R, Ecker JL, Thadhani R. Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus. Diabetes Care. 2004 Jan;27(1):21–27.

Published In

Diabetes Care

DOI

ISSN

0149-5992

Publication Date

January 2004

Volume

27

Issue

1

Start / End Page

21 / 27

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pregnancy
  • Inflammation
  • Infant, Newborn
  • Humans
  • Glucose Intolerance
  • Gestational Age
  • Female
  • Endocrinology & Metabolism
  • Diabetes, Gestational