Prepregnancy Fat Free Mass and Associations to Glucose Metabolism Before and During Pregnancy

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Abstract
Objective Our aim was to quantify the individual contribution of pre-pregnancy (PP) fat-free mass (FFM), expressed as PP-FFM index [PP-FFMI=FFM (kg)/height (m2)], on markers of glucose homeostasis before and during pregnancy. Methods Body composition was assessed in 43 women before pregnancy using air-displacement plethysmography. Blood was drawn at PP and gestation week ̴̴8 and 30. Relationships between body composition (independent) variables and glucose homeostasis (dependent) variables were assessed using adjusted correlations, and simple and multiple linear regression analyses. Results At PP, FFMI was the strongest predictor of plasma insulin concentration (Pr2=17, p=0.007) and HOMA2-IR (Pr2=16, p=0.010). At gestation week 30, PP-FFMI and gestational weight gain (GWG) were the strongest predictors of insulin concentration (PP-FFMI: Pr2=20, p=0.010; GWG: Pr2=12, p=0.052), HOMA2-IR (PP-FFMI: Pr2=19, p=0.012; GWG: Pr2=13, p=0.045). After accounting for PP fat mass index (PP-FMI), PP-FFMI and GWG were independently associated with 1st phase insulin response (PP-FFMI: Pr2=20, p=0.009; GWG: Pr2=15, p=0.025), and 2nd phase insulin response (PP-FFMI: Pr2=19, p=0.011; GWG: Pr2=17, p=0.016). PP-FMI was the strongest predictor of OGTT derived estimated metabolic clearance rate of glucose (PP-FMI: Pr2=14, p=0.037), and estimated Insulin sensitivity index (PP-FMI: Pr2=13, p=0.047). Conclusions PP-FFMI was a predictor of markers of glucose homeostasis before and during pregnancy. Studies assessing the impact of skeletal muscle quality on metabolic regulation during pregnancy are warranted.
Funding Information
  • Arkansas Biosciences Institute
  • Agricultural Research Service (6026-51000-010-05S)
  • National Institutes of Health

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