Increased gallbladder emptying and reduced GLP-1 response in pregnancy with and without gestational diabetes mellitus.

IF 5.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Ida M Gether, Emilie S Andersen, Signe Foghsgaard, Anne-Marie Ellegaard, Louise Kelstrup, David P Sonne, Andreas Brønden, Matthew P Gillum, Jens J Holst, Bolette Hartmann, Jens F Rehfeld, Tina Vilsbøll, Filip K Knop
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引用次数: 0

Abstract

Aim: Gestational diabetes mellitus (GDM) has been associated with reduced postprandial glucagon-like peptide 1 (GLP-1) responses. As pregnancy induces changes in gallbladder motility and bile acids stimulate GLP-1 secretion, we investigated postprandial gallbladder emptying and GLP-1 responses in women with GDM.

Methods: Women with and without GDM underwent two 240-min mixed meal tests; one during third trimester of pregnancy and one 3-6 months postpartum. We evaluated ultrasonography-assessed gallbladder emptying, plasma concentrations of glucometabolic hormones including GLP-1, paracetamol absorption (proxy for gastric emptying) and circulating factors known to affect gallbladder dynamics.

Results: Fifteen women with GDM and 15 pregnant women with normal glucose tolerance (NGT) (baseline median age 31 (interquartile range 29;33) versus 32 (28;33) years, body mass index (BMI) 27.2 (24.7;30.7) versus 28.4 (26.2;31.0) kg/m2, HbA1c 30 (29;32) versus 30 (28;31) mmol/mol) were included. No differences in postprandial gallbladder emptying or GLP-1 responses were observed between women with and without GDM, neither during pregnancy nor postpartum. Pregnancy increased fasting gallbladder volumes by 69 (30;122)% and 103 (59;156)% and postprandial gallbladder emptying by 77 (28;236)% and 99 (37;190)% compared with postpartum in women with and without GDM, respectively. Postprandial GLP-1 responses were reduced by 60 (3;82)% and 81 (11;90)% during pregnancy compared with postpartum in women with and without GDM, respectively.

Conclusion: Pregnancy-induced changes in gallbladder motility seem to play no or a limited role in previously reported GDM-associated reduced postprandial GLP-1 responses as gallbladder emptying was greater and postprandial GLP-1 response was lower in pregnancy than postpartum regardless of GDM status.

妊娠合并或不合并妊娠糖尿病时,胆囊排空增加,GLP-1 反应减弱。
目的:妊娠糖尿病(GDM)与餐后胰高血糖素样肽 1(GLP-1)反应降低有关。由于妊娠会引起胆囊蠕动的变化,而胆汁酸会刺激 GLP-1 的分泌,因此我们研究了 GDM 妇女的餐后胆囊排空和 GLP-1 反应:患有和未患有 GDM 的女性接受了两次 240 分钟混合餐测试,一次在妊娠三个月期间,另一次在产后 3-6 个月。我们评估了超声波评估的胆囊排空、包括 GLP-1 在内的糖代谢激素的血浆浓度、扑热息痛的吸收(胃排空的替代物)以及已知会影响胆囊动力学的循环因素:15 名 GDM 孕妇和 15 名糖耐量正常 (NGT) 孕妇(基线中位年龄 31(四分位间范围 29;33)岁对 32(28;33)岁,体重指数(BMI)27.2(24.7;30.7)千克/平方米对 28.4(26.2;31.0)千克/平方米,HbA1c 30(29;32)毫摩尔/摩尔对 30(28;31)毫摩尔/摩尔)。无论是在孕期还是产后,患有和未患有 GDM 的妇女餐后胆囊排空或 GLP-1 反应均无差异。与产后相比,妊娠使患有和未患有 GDM 的妇女的空腹胆囊容积分别增加了 69 (30;122)% 和 103 (59;156)%,餐后胆囊排空分别增加了 77 (28;236)% 和 99 (37;190)%。与产后相比,妊娠期和未患 GDM 的妇女餐后 GLP-1 反应分别减少了 60 (3;82)% 和 81 (11;90)%:结论:妊娠引起的胆囊蠕动变化似乎在之前报道的与 GDM 相关的餐后 GLP-1 反应降低中不起作用或作用有限,因为无论 GDM 状况如何,妊娠期胆囊排空都比产后大,餐后 GLP-1 反应也比产后低。
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来源期刊
Diabetes, Obesity & Metabolism
Diabetes, Obesity & Metabolism 医学-内分泌学与代谢
CiteScore
10.90
自引率
6.90%
发文量
319
审稿时长
3-8 weeks
期刊介绍: Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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