PDF(Pubmed)
Abstract：
Prolactin is a multifaceted hormone known to regulate lactation. In women with gestational diabetes mellitus (GDM) history, intensive lactation has been associated with lower relative risk of future type 2 diabetes (T2D). However, the role of prolactin in T2D development and maternal metabolism in women with a recent GDM pregnancy has not been ascertained.
We examined the relationships among prolactin, future T2D risk, and key clinical and metabolic parameters.
We utilized a prospective GDM research cohort (the SWIFT study) and followed T2D onset by performing 2-hour 75-g research oral glucose tolerance test (OGTT) at study baseline (6-9 weeks postpartum) and again annually for 2 years, and also by retrieving clinical diagnoses of T2D from 2 years through 10 years of follow up from electronic medical records. Targeted metabolomics and lipidomics were applied on fasting plasma samples collected at study baseline from 2-hour 75-g research OGTTs in a nested case-control study (100 future incident T2D cases vs 100 no T2D controls).
Decreasing prolactin quartiles were associated with increased future T2D risk (adjusted odds ratio 2.48; 95% CI, 0.81-7.58; P = 0.05). In women who maintained normoglycemia during the 10-year follow-up period, higher prolactin at baseline was associated with higher insulin sensitivity (P = 0.038) and HDL-cholesterol (P = 0.01), but lower BMI (P = 0.001) and leptin (P = 0.002). Remarkably, among women who developed future T2D, prolactin was not correlated with a favorable metabolic status (all P > 0.05). Metabolomics and lipidomics showed that lower circulating prolactin strongly correlated with a T2D-high risk lipid profile, with elevated circulating neutral lipids and lower concentrations of specific phospholipids/sphingolipids.
In women with recent GDM pregnancy, low circulating prolactin is associated with specific clinical and metabolic parameters and lipid metabolites linked to a high risk of developing T2D.
We examined the relationships among prolactin, future T2D risk, and key clinical and metabolic parameters.
We utilized a prospective GDM research cohort (the SWIFT study) and followed T2D onset by performing 2-hour 75-g research oral glucose tolerance test (OGTT) at study baseline (6-9 weeks postpartum) and again annually for 2 years, and also by retrieving clinical diagnoses of T2D from 2 years through 10 years of follow up from electronic medical records. Targeted metabolomics and lipidomics were applied on fasting plasma samples collected at study baseline from 2-hour 75-g research OGTTs in a nested case-control study (100 future incident T2D cases vs 100 no T2D controls).
Decreasing prolactin quartiles were associated with increased future T2D risk (adjusted odds ratio 2.48; 95% CI, 0.81-7.58; P = 0.05). In women who maintained normoglycemia during the 10-year follow-up period, higher prolactin at baseline was associated with higher insulin sensitivity (P = 0.038) and HDL-cholesterol (P = 0.01), but lower BMI (P = 0.001) and leptin (P = 0.002). Remarkably, among women who developed future T2D, prolactin was not correlated with a favorable metabolic status (all P > 0.05). Metabolomics and lipidomics showed that lower circulating prolactin strongly correlated with a T2D-high risk lipid profile, with elevated circulating neutral lipids and lower concentrations of specific phospholipids/sphingolipids.
In women with recent GDM pregnancy, low circulating prolactin is associated with specific clinical and metabolic parameters and lipid metabolites linked to a high risk of developing T2D.
摘要：
催乳素是一种多方面的激素，已知可调节泌乳。在有妊娠期糖尿病（GDM）病史的女性中，密集泌乳与未来2型糖尿病(T2D)的相对风险较低相关.然而,催乳素在最近GDM妊娠妇女T2D发育和母体代谢中的作用尚未确定.
我们检查了催乳素，未来的T2D风险，以及关键的临床和代谢参数。
我们使用前瞻性GDM研究队列（SWIFT研究），并通过在研究基线（产后6-9周）进行2小时75-g研究口服葡萄糖耐量试验（OGTT），并每年进行2年，还通过从电子病历中检索2年到10年随访的T2D临床诊断。靶向代谢组学和脂质组学应用于在研究基线时从嵌套病例对照研究中的2小时75-g研究OGTT收集的空腹血浆样品(100个未来事件T2D病例对比100个无T2D对照)。
催乳素四分位数的降低与未来T2D风险的增加相关（校正比值比2.48；95％CI，0.81-7.58；P=0.05）。在10年随访期间保持血糖正常的女性中，基线时更高的催乳素与更高的胰岛素敏感性(P=0.038)和HDL-胆固醇(P=0.01)相关,但BMI(P=0.001)和瘦素(P=0.002)较低。值得注意的是,在发展未来T2D的女性中，催乳素与良好的代谢状态无关（均P>0.05）。代谢组学和脂质组学显示，低循环催乳素与T2D高风险血脂谱密切相关。具有升高的循环中性脂质和较低浓度的特定磷脂/鞘脂。
在最近GDM怀孕的女性中，低循环催乳素与特定的临床和代谢参数相关,脂质代谢产物与发生T2D的高风险相关.
我们检查了催乳素，未来的T2D风险，以及关键的临床和代谢参数。
我们使用前瞻性GDM研究队列（SWIFT研究），并通过在研究基线（产后6-9周）进行2小时75-g研究口服葡萄糖耐量试验（OGTT），并每年进行2年，还通过从电子病历中检索2年到10年随访的T2D临床诊断。靶向代谢组学和脂质组学应用于在研究基线时从嵌套病例对照研究中的2小时75-g研究OGTT收集的空腹血浆样品(100个未来事件T2D病例对比100个无T2D对照)。
催乳素四分位数的降低与未来T2D风险的增加相关（校正比值比2.48；95％CI，0.81-7.58；P=0.05）。在10年随访期间保持血糖正常的女性中，基线时更高的催乳素与更高的胰岛素敏感性(P=0.038)和HDL-胆固醇(P=0.01)相关,但BMI(P=0.001)和瘦素(P=0.002)较低。值得注意的是,在发展未来T2D的女性中，催乳素与良好的代谢状态无关（均P>0.05）。代谢组学和脂质组学显示，低循环催乳素与T2D高风险血脂谱密切相关。具有升高的循环中性脂质和较低浓度的特定磷脂/鞘脂。
在最近GDM怀孕的女性中，低循环催乳素与特定的临床和代谢参数相关,脂质代谢产物与发生T2D的高风险相关.
