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Title: Adiposity, related biomarkers, and type 2 diabetes after gestational diabetes: The Diabetes Prevention Program
Authors: Wander, Pandora L 
Christophi, Costas A. 
Araneta, Maria Rosario G 
Boyko, Edward J 
Enquobahrie, Daniel A 
Dabelea, Dana 
Goldberg, Ronald B 
Kahn, Steven E 
Kim, Catherine 
Pi-Sunyer, Xavier 
Knowler, William C 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Adiposity;Biomarkers;Diabetes Mellitus;Diabetes;Gestational;Humans;Obesity;Pregnancy
Issue Date: 1-Jan-2022
Source: Obesity, 2022, vol.30, iss.1, pp. 221 - 228
Volume: 30
Issue: 1
Start page: 221
End page: 228
Abstract: Objective: This study investigated associations of adiposity and adiposity-related biomarkers with incident type 2 diabetes (T2D) among parous women. Methods: Among women in the Diabetes Prevention Program (DPP) who reported a previous live birth, circulating biomarkers (leptin, adiponectin, sex hormone-binding globulin, and alanine aminotransferase; n = 1,711) were measured at enrollment (average: 12 years post partum). Visceral (VAT) and subcutaneous adipose tissue areas at the L2-L3 region and the L3-L4 region were quantified by computed tomography (n = 477). Overall and stratified (by history of gestational diabetes mellitus [GDM]) adjusted Cox proportional hazards models were fit. Results: Alanine aminotransferase, L2-L3 VAT, and L3-L4 VAT were positively associated (hazard ratio [HR] for 1-SD increases: 1.073, p = 0.024; 1.251, p = 0.009; 1.272, p = 0.004, respectively), and adiponectin concentration was inversely associated with T2D (HR 0.762, p < 0.001). Whereas leptin concentration was not associated with T2D overall, in GDM-stratified models, a 1-SD higher leptin was positively associated with risk of T2D in women without GDM (HR: 1.126, p = 0.016) and inversely in women with a history of GDM (HR: 0.776, p = 0.013, interaction p = 0.002). Conclusions: Among parous women, alanine aminotransferase and VAT are positively associated with incident T2D, whereas adiponectin is inversely associated. Leptin is associated with higher risk of T2D in women with a history of GDM but a lower risk in women without a history of GDM. © 2021 The Obesity Society (TOS). This article has been contributed to by US Government employees and their work is in the public domain in the USA.
ISSN: 19307381
DOI: 10.1002/oby.23291
Rights: © The Obesity Society
Attribution-NonCommercial-NoDerivatives 4.0 International
Type: Article
Affiliation : Veterans Affairs Puget Sound Health Care System 
University of Washington 
George Washington University 
University of California, San Diego 
Colorado School of Public Health 
University of Miami 
University of Michigan 
Columbia University Medical Center 
National Institute of Diabetes and Digestive and Kidney Diseases 
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