Difference in Visceral Adipose Tissue in Pregnancy and Postpartum and Related Changes in Maternal Insulin Resistance. (31st August 2018)

• Record Type: Journal Article
• Authors: Shinar, Shiri; Berger, Howard; De Souza, Leanne R.; Ray, Joel G.
• Is Part Of: Journal of ultrasound in medicine. Volume 38:Number 3(2019)
• Page Start: 667
• Page End: 673
• Publication Date: 2018-08-31
• Subjects: adiposity -- body mass index -- insulin resistance -- postpartum -- ultrasound -- visceral adipose tissue; Ultrasonics in medicine -- Periodicals; Ultrasonics; Ultrasonography; Ultrasonics in medicine; Electronic journals; Periodicals; Periodicals; 616.07543
• DOI: 10.1002/jum.14737
• Languages: English
• ISSNs: 0278-4297

Abstract

Abstract : Objective: To measure the difference between first‐trimester and postpartum visceral adipose tissue (VAT), the agreement of this difference with change in body mass index, and whether a difference in VAT is associated with insulin resistance or glucose mishandling. Methods: Prospective study of 93 women with singleton pregnancies without a history of diabetes. Visceral adipose tissue depth was sonographically assessed at 11 to 14 weeks and at 6 to 12 weeks postpartum. Metabolic measures, sampled at 24 to 28 weeks and 6 to 12 weeks postpartum, included homeostatic model assessment of insulin resistance, insulin sensitivity index composite, and area under the 75‐g oral glucose tolerance test curve. Results: First‐trimester VAT depth explained only 37% (95% confidence interval [CI], 22–52) of the variation in postpartum VAT depth. There was limited agreement between the net change in postpartum minus first‐trimester VAT depth and that same net change for body mass index (Cohen's kappa, 0.26; 95% CI, 0.05–0.47). Those with a net gain in VAT depth demonstrated poorer insulin sensitivity index postpartum than women with a net regression in VAT depth—a difference of –2.0 (95% CI, –3.3 to –0.69). Conclusion: Sonographic assessment of postpartum VAT is feasible and may provide insight to metabolic changes between pregnancy and postpartum, beyond body mass index.