Poster Session 3
Category: Diabetes
Poster Session 3
Megumi Koga, MD
NHO Nagasaki Medical Center
Omura, Nagasaki, Japan
Katsuhito Hayashi, MS
NHO Ureshino Medical Center
Ureshino, Saga, Japan
Ichiro Yasuhi, MD
Adviser
NHO Nagasaki Medical Center
Omura, Nagasaki, Japan
Women with a history of gestational diabetes (GDM) face a high risk of developing type 2 diabetes postpartum. Skeletal muscle is a major site of insulin-mediated glucose uptake, and low muscle mass may impair glucose regulation. This study examined whether appendicular skeletal muscle index (ASM-I) in early postpartum is associated with β-cell compensation and fasting glucose status during two-year follow-up in women with prior GDM.
This secondary analysis used data from a prospective observational study at a tertiary perinatal center in Japan. Singleton women with prior GDM underwent postpartum metabolic assessments including a 75g oral glucose tolerance test (OGTT) at 6-9 weeks, and follow-up OGTTs at 6 months, 1 year, and 2 years. Appendicular skeletal muscle mass was measured using bioelectrical impedance analysis at 4 weeks postpartum. ASM-I was calculated as muscle mass divided by body weight. The primary outcome was disposition index (DI) from the first follow-up OGTT. Secondary outcomes included fasting plasma glucose (FPG) and insulin levels across follow-up points. Associations were analyzed using multivariable linear regression models.
Among 139 women (mean age 34.0 ± 5.0 years; BMI 24.5 ± 5.2 kg/m²), higher ASM-I at 4 weeks postpartum was significantly associated with greater DI at the first follow-up OGTT (β = 0.28, p < 0.005), indicating better β-cell compensation. ASM-I was also inversely associated with FPG and insulin levels at 6 months, 1 year, and 2 years (all p < 0.05). Women in the lowest ASM-I quartile had persistently elevated FPG and insulin, suggestive of insulin resistance and β-cell dysfunction.