Relationship of lactation, BMI, and rs12255372 TCF7L2 polymorphism on the conversion to type 2 diabetes mellitus in women with previous gestational diabetes

Abstract

Women with previous gestational diabetes mellitus (pGDM) have a high risk of developing postpartum type 2 diabetes mellitus (T2DM). This study aimed to analyze the relationship between lactation, BMI, and TCF7L2 polymorphisms in the conversion to T2DM in women with pGDM. One hundred and fifty-three women con pGDM were recruited from public hospitals of León Guanajuato México. Three groups: normal glucose tolerance (NGT), impaired glucose intolerance (IGT), and T2DM after the oral glucose tolerance test were formed. Metabolic and hormone variables were measured, and genotyping was made by PCR-RFLP. The questionnaire included data on lactation (yes/no), duration of lactation, and full lactation. After 35 (21–49) months from the last partum, 54% of women had an NGT, 30.7% IGT, and 15% T2DM. BMI and rs12255372 are associated with the risk of conversion to IGT and T2DM [OR = 1.07 (95% IC 1.0–1.14, p = .041; OR =2.14, 95% IC 1.01–4.55, p = .04 respectively), while the lactation shows a strong protective effects OR = 0.15 (95% IC 0.062–0.39, p = .00007), and an apparent interaction with rs12255372T decreasing the risk in carriers (OR =2.15; 95% IC 0.97–4.7, p = .05). BMI is an independent risk factor of IGT/T2DM development. The lactation shows a strong protective effect and a possible interaction with rs12255372 polymorphism.

摘要

既往患有妊娠期糖尿病(pGDM)的女性有产后患2型糖尿病(T2DM)的高风险。此项研究目的是分析哺乳期, BMI和TCF7L2基因多态性与既往妊娠期糖尿病患者转化为2型糖尿病之间的关系。从墨西哥瓜纳华托列昂公立医院共招募了153名既往患有妊娠期糖尿病的女性。依据口服糖耐量试验结果分为3组：糖耐量正常组(NGT), 糖耐量受损组(IGT), T2DM组。测量代谢和激素水平指标, 通过用聚合酶链反应-限制性片段长度多态性方法（PCR-RFLP）进行基因分型。调查问卷包括哺乳期（是/否）、哺乳期的持续时间和整个哺乳期的数据。从产后开始35（21-49）个月后, NGT组占54%, IGT组占30.7%, T2DM组占15%。BMI 和rs12255372与转化为IGT和T2DM的风险相关[OR=1.07 (分别95% IC 1.0-1.14, p=.041; OR = 2.14, 95% IC 1.01-4.55, p = .04 )]。而哺乳期表现出很强的保护性作用OR=0.15 (95% IC 0.062=0.39, p=.00007), 并且在携带rs12255372T基因的患者中显示相互作用降低患病风险(OR =2.15; 95% IC 0.97=4.7, p=.05)。BMI是发展为IGT/T2DM的独立危险因素, 哺乳期显示出很强的保护作用, 并可能与rs12255372基因多态性之间相互影响。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• T2DM
• TCF7L2 polymorphisms
• pGDM
• lactation
• BMI

Acknowledgements

We thank the General Hospital and Maternal-Infant Hospital of Health Ministry in León Guanajuato, Health Ministry of Guanajuato, México.

Disclosure statement

The authors state that there is no direct or indirect conflict of interest.

Additional information

Funding

This work was supported by The Research Program of the Direction of Support to Investigation and Postgraduate, University of Guanajuato, Mexico 2014.