Less sedentary time is associated with a more favourable glucose-insulin axis in obese pregnant women-a secondary analysis of the DALI study.


Journal

International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108

Informations de publication

Date de publication:
02 2021
Historique:
received: 16 03 2020
accepted: 03 07 2020
pubmed: 15 7 2020
medline: 4 1 2022
entrez: 15 7 2020
Statut: ppublish

Résumé

Obese pregnant women are at high risk of developing gestational diabetes mellitus (GDM), which might be reduced by sufficient physical activity (PA) and reduced sedentary time (ST). We assessed whether PA and ST are longitudinally associated with the glucose-insulin axis in obese pregnant women. In this secondary analysis of the DALI (vitamin D And Lifestyle Intervention for gestational diabetes mellitus prevention) study, pregnant women, <20 weeks gestation, with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m 232 women were included in the analysis. Concerning differences between participants, more ST was associated with higher fasting glucose (Estimate: 0.008; 95% CI: 0.002, 0.014), fasting insulin (0.011; 0.002, 0.019), HOMA-IR (0.012; 0.004, 0.021) and Stumvoll first and second phase (0.008; 0.001, 0.014 and 0.007; 0.001, 0.014). Participants with more MVPA had lower Stumvoll first and second phase (-0.137; -0.210, -0.064 and -0.133; -0.202, -0.063). Concerning changes over time, an increase in ST during gestation was associated with elevated Stumvoll first and second phase (0.006; 0.000, 0.011). As the glucose-insulin axis is more strongly associated with ST than MVPA in our obese population, pregnant women could be advised to reduce ST in addition to increasing MVPA. Moreover, our findings suggest that behaviour change interventions aiming at GDM risk reduction should start in early or pre-pregnancy.

Sections du résumé

BACKGROUND/OBJECTIVES
Obese pregnant women are at high risk of developing gestational diabetes mellitus (GDM), which might be reduced by sufficient physical activity (PA) and reduced sedentary time (ST). We assessed whether PA and ST are longitudinally associated with the glucose-insulin axis in obese pregnant women.
SUBJECTS/METHODS
In this secondary analysis of the DALI (vitamin D And Lifestyle Intervention for gestational diabetes mellitus prevention) study, pregnant women, <20 weeks gestation, with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m
RESULTS
232 women were included in the analysis. Concerning differences between participants, more ST was associated with higher fasting glucose (Estimate: 0.008; 95% CI: 0.002, 0.014), fasting insulin (0.011; 0.002, 0.019), HOMA-IR (0.012; 0.004, 0.021) and Stumvoll first and second phase (0.008; 0.001, 0.014 and 0.007; 0.001, 0.014). Participants with more MVPA had lower Stumvoll first and second phase (-0.137; -0.210, -0.064 and -0.133; -0.202, -0.063). Concerning changes over time, an increase in ST during gestation was associated with elevated Stumvoll first and second phase (0.006; 0.000, 0.011).
CONCLUSIONS
As the glucose-insulin axis is more strongly associated with ST than MVPA in our obese population, pregnant women could be advised to reduce ST in addition to increasing MVPA. Moreover, our findings suggest that behaviour change interventions aiming at GDM risk reduction should start in early or pre-pregnancy.

Identifiants

pubmed: 32661292
doi: 10.1038/s41366-020-0639-y
pii: 10.1038/s41366-020-0639-y
pmc: PMC7840500
doi:

Substances chimiques

Blood Glucose 0
Insulin 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

296-307

Subventions

Organisme : Austrian Science Fund FWF
ID : DOC 31
Pays : Austria
Organisme : Department of Health
Pays : United Kingdom

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Auteurs

Anna M Dieberger (AM)

Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria. anna.dieberger@medunigraz.at.

Gernot Desoye (G)

Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.

Erwin Stolz (E)

Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.

David J Hill (DJ)

Recherche en Santé Lawson SA, Bronschhofen, Switzerland.
Lawson Health Research Institute, London, ON, N6C 2R5, Canada.

Rosa Corcoy (R)

Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.
CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain.

David Simmons (D)

Macarthur Clinical School, Western Sydney University, Sydney, Australia.

Jürgen Harreiter (J)

Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Alexandra Kautzky-Willer (A)

Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Fidelma Dunne (F)

Galway Diabetes Research Centre and College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland.

Roland Devlieger (R)

KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.

Ewa Wender-Ozegowska (E)

Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland.

Agnieszka Zawiejska (A)

Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland.

Annunziata Lapolla (A)

Universita Degli Studi di Padova, Padua, Italy.

Maria Grazia Dalfra (MG)

Universita Degli Studi di Padova, Padua, Italy.

Alessandra Bertolotto (A)

Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.

Sander Galjaard (S)

Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.

Juan M Adelantado (JM)

Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Dorte Møller Jensen (DM)

Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

Lise-Lotte Andersen (LL)

Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

Mette Tanvig (M)

Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

Peter Damm (P)

Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Elisabeth Reinhardt Mathiesen (ER)

Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Frank J Snoek (FJ)

Department of Medical Psychology, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.

Judith G M Jelsma (JGM)

Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Mireille N M van Poppel (MNM)

Institute of Sport Science, University of Graz, Graz, Austria.

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Classifications MeSH