Publication Description
Aim To examine concentrations of biomarkers (adiponectin, C‐reactive protein, fibrinogen and tissue plasminogen‐activator antigen) associated with glucose homeostasis and diabetes risk by history of gestational diabetes (GDM). Methods We conducted a secondary analysis of the Diabetes Prevention Program, a randomized trial of lifestyle intervention or metformin for diabetes prevention. At baseline, participants were overweight and had impaired glucose tolerance. Biomarkers at baseline and 1 year after enrolment were compared between parous women with (n = 350) and without histories of GDM (n = 1466). Cox proportional hazard models evaluated whether history of GDM was associated with diabetes risk, after adjustment for baseline biomarker levels as well as for change in biomarker levels, demographic factors and anthropometrics. Results At baseline, women with histories of GDM had lower adiponectin (7.5 μg/ml vs. 8.7 μg/ml; p < 0.0001) and greater log C‐reactive protein (‐0.90 mg/l vs. ‐0.78 mg/l, p = 0.04) levels than women without histories of GDM, but these associations did not persist after adjustment for demographic factors. Fibrinogen and tissue plasminogen‐activator antigen were similar between women with and without histories of GDM. Women with and without histories of GDM had a similar pattern of changes in biomarkers within randomization arm. Adjustment for age, race/ethnicity, baseline weight, change in weight, baseline biomarker level and change in biomarker level did not significantly alter the association between history of GDM, and diabetes risk. Conclusions Among women with impaired glucose tolerance, biomarkers in women with and without histories of GDM are similar and respond similarly to lifestyle changes and metformin. Adjustment for biomarker levels did not explain the higher risk of diabetes observed in women with histories of GDM. What's new? This is the first study to examine whether biomarkers, including C‐reactive protein, adiponectin, fibrinogen and tissue plasminogen‐activating antigen, explain the higher diabetes risk of women with histories of gestational diabetes (GDM). This is the first study to determine whether concentrations of biomarkers associated with abnormal glucose homeostasis respond similarly to lifestyle changes and metformin among women with and without histories of GDM. Among women with impaired glucose tolerance, these biomarkers do not explain the higher diabetes risk observed in women with histories of GDM.