University of Oulu

Mustaniemi, S, Morin-Papunen, L, Keikkala, E, et al. Associations of low sex hormone-binding globulin and androgen excess in early pregnancy with fasting and post-prandial hyperglycaemia, gestational diabetes and its severity. Diabetes Metab Res Rev. 2022;e3599. https://doi.org/10.1002/dmrr.3599

Associations of low sex hormone-binding globulin and androgen excess in early pregnancy with fasting and post-prandial hyperglycaemia, gestational diabetes, and its severity

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Author: Mustaniemi, Sanna1; Morin-Papunen, Laure1; Keikkala, Elina1,2;
Organizations: 1Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
2Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Helsinki, Finland
3Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland
4Faculty of Medicine, Medical Research Center, University of Oulu, Oulu, Finland
5Institute of Clinical Medicine, Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland
6Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
7Academic Primary Health Care Centre, Region Stockholm and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
8Department of General Practice and Primary Health Care, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
9Folkhälsan Research Center, Helsinki, Finland
10Department of Obstetrics and Gynecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
11Department of Obstetrics and Gynecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Center for Child, Adolescence and Maternal Health, Tampere University, Tampere, Finland
12Medical and Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
13Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
14Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
15Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202301021095
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2023-01-02
Description:

Abstract

Aims: We studied whether androgen excess and low sex hormone-binding globulin (SHBG) measured in early pregnancy are independently associated with fasting and post-prandial hyperglycaemia, gestational diabetes (GDM), and its severity.

Materias and Methods: This nationwide case–control study included 1045 women with GDM and 963 non-diabetic pregnant controls. We measured testosterone (T) and SHBG from biobanked serum samples (mean 10.7 gestational weeks) and calculated the free androgen index (FAI). We first studied their associations with GDM and secondly with the type of hyperglycaemia (fasting, 1 and 2 h glucose concentrations during the oral glucose tolerance test), early-onset GDM (<20 gestational weeks) and the need for anti-diabetic medication.

Results: After adjustments for gestational weeks at sampling, pre-pregnancy BMI, and age, women with GDM had 3.7% (95% CI 0.1%–7.3%) lower SHBG levels, 3.1% (95% CI 0.1%–6.2%) higher T levels, and 4.6% (95% CI 1.9%–7.3%) higher FAI levels than controls. SHBG was inversely associated with fasting glucose, whereas higher FAI and T were associated with higher post-prandial glucose concentrations. Women with early-onset GDM had 6.7% (95% CI 0.7%–12.7%) lower SHBG levels and women who needed insulin for fasting hyperglycaemia 8.7% (95% CI 1.8%–14.8%) lower SHBG levels than other women with GDM.

Conclusions: Lower SHBG levels were associated especially with early-onset GDM, higher fasting glucose and insulin treatment, whereas androgen excess was associated with higher post-prandial glucose values. Thus, a low SHBG level may reflect the degree of existing insulin resistance, while androgen excess might impair post-prandial insulin secretion.

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Series: Diabetes/metabolism research and reviews
ISSN: 1520-7552
ISSN-E: 1520-7560
ISSN-L: 1520-7552
Volume: In press
DOI: 10.1002/dmrr.3599
OADOI: https://oadoi.org/10.1002/dmrr.3599
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Subjects:
Funding: This study was supported by the Academy of Finland (grant numbers 127437, 128929, 129306, 130326, 134791 and 274794), the Foundation for Pediatric Research, the Diabetes Research Foundation, the Juho Vainio Foundation, the Novo Nordisk Foundation, the Signe and Ane Gyllenberg Foundation, the Sigrid Jusélius Foundation, the Yrjö Jahnsson Foundation, and Medical Research Center Oulu.
Copyright information: © 2022 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License,which permits use,distribution and reproduction in any medium, provided the original work is properly cited.
  https://creativecommons.org/licenses/by/4.0/