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Determinants of insulin resistance among Mexican pregnant women

Impaired glucose tolerance is associated with adverse pregnancy outcomes. Early detection would allow implementing interventions to reduce progression to Gestational Diabetes Mellitus (GDM). Hispanic women are a risk group for GDM. The objective was to identify biochemical, anthropometric and dietary factors that predict insulin resistance, Homeostasis Model Assessment‐Insulin Resistance (HOMA‐IR), at 16‐20 or 26‐30 wk gestation in 109 pregnant women living in Mexico City. Maternal health history, anthropometry and dietary intakes were measured at 16‐20 wk . Dietary intakes were assessed using a validated food frequency questionnaire. Fasting insulin, glucose, adiponectin, and leptin concentrations were measured at 16‐20 and 26‐30 wk. HOMA‐IR and leptin increased (HOMA‐IR: 2.6±1.5 to 3.1±1.9 and leptin: 25.5 ± 12 to 27.3 ± 14 ng/mL) while adiponectin decreased between time points (12.1 ± 5 to 11.5 ± 5 ug/mL). At 16‐20 wks, stepwise multiple regression analysis showed that maternal weight, fasting leptin and adiponectin concentrations were the strongest predictors of HOMA‐IR. At 26‐30 wks, sugar intake, maternal weight and subscapular skinfold thicknesses best predicted HOMA‐IR. Maternal weight was the only variable predicting HOMA‐IR at both mid and late pregnancy. These results support programs targeting overweight and obese women for weight control to reduce the risk of GDM. Funded by UCMexus.