Less sedentary time is associated with a more favourable glucose-insulin axis in obese pregnant women-a secondary analysis of the DALI study
Por:
Dieberger, AM, Desoye, G, Stolz, E, Hill, DJ, Corcoy, R, Simmons, D, Harreiter, J, Kautzky-Willer, A, Dunne, F, Devlieger, R, Wender-Ozegowska, E, Zawiejska, A, Lapolla, A, Dalfra, MG, Bertolotto, A, Galjaard, S, Adelantado, JM, Jensen, DM, Andersen, LL, Tanvig, M, Damm, P, Mathiesen, ER, Snoek, FJ, Jelsma, JGM, van Poppel, MNM
Publicada:
1 feb 2021
Ahead of Print:
1 jul 2020
Resumen:
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(2), without GDM on entry were included. Time spent in moderate-to-vigorous PA (MVPA) and ST were measured objectively with accelerometers at<20 weeks, 24-28 weeks and 35-37 weeks of gestation. Fasting glucose (mmol/l) and insulin (mU/l), insulin resistance (HOMA-IR) and first-phase and second-phase insulin release (Stumvoll first and second phase) were assessed at the same time. Linear mixed regression models were used to calculate between-participant differences and within-participant changes over time. Analyses were adjusted for gestational age, randomisation, pre-pregnancy BMI, education and age. MVPA, Insulin, HOMA-IR and Stumvoll first and second phase were log-transformed for analyses due to skewness. 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.
Filiaciones:
Dieberger, AM:
Med Univ Graz, Dept Obstet & Gynaecol, Graz, Austria
Desoye, G:
Med Univ Graz, Dept Obstet & Gynaecol, Graz, Austria
Stolz, E:
Med Univ Graz, Inst Social Med & Epidemiol, Graz, Austria
Hill, DJ:
Rech Sante Lawson SA, Bronschhofen, Switzerland
Lawson Hlth Res Inst, London, ON N6C 2R5, Canada
Corcoy, R:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol, Madrid, Spain
Simmons, D:
Western Sydney Univ, Macarthur Clin Sch, Sydney, NSW, Australia
Harreiter, J:
Med Univ Vienna, Dept Med 3, Div Endocrinol & Metab, Gender Med Unit, Vienna, Austria
Kautzky-Willer, A:
Med Univ Vienna, Dept Med 3, Div Endocrinol & Metab, Gender Med Unit, Vienna, Austria
Dunne, F:
Natl Univ Ireland, Galway Diabet Res Ctr, Galway, Ireland
Natl Univ Ireland, Coll Med Nursing & Hlth Sci, Galway, Ireland
Devlieger, R:
Katholieke Univ Leuven, Univ Hosp Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Leuven, Belgium
Wender-Ozegowska, E:
Poznan Univ Med Sci, Div Reprod, Poznan, Poland
Zawiejska, A:
Poznan Univ Med Sci, Div Reprod, Poznan, Poland
Lapolla, A:
Univ Padua, Padua, Italy
Dalfra, MG:
Univ Padua, Padua, Italy
Bertolotto, A:
Azienda Osped Univ Pisana, Pisa, Italy
Galjaard, S:
Erasmus MC, Univ Med Ctr Rotterdam, Div Obstet & Prenatal Med, Dept Obstet & Gynaecol, Rotterdam, Netherlands
Adelantado, JM:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Jensen, DM:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Andersen, LL:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Tanvig, M:
Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Damm, P:
Rigshosp, Ctr Pregnant Women Diabet, Dept Endocrinol, Copenhagen, Denmark
Rigshosp, Dept Obstet, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
Mathiesen, ER:
Rigshosp, Ctr Pregnant Women Diabet, Dept Endocrinol, Copenhagen, Denmark
Rigshosp, Dept Obstet, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
Snoek, FJ:
Vrije Univ Amsterdam, Amsterdam Univ, Amsterdam Publ Hlth Res Inst, Dept Med Psychol,Med Ctr, Amsterdam, Netherlands
Jelsma, JGM:
Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Publ & Occupat Hlth, Amsterdam, Netherlands
van Poppel, MNM:
Karl Franzens Univ Graz, Inst Sport Sci, Graz, Austria
Green Published, Hybrid Gold
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