Physical fitness and plasma leptin in women with recent gestational diabetes

C Gar; M Rottenkolber; H Grallert; F Banning; I Freibothe; V Sacco; C Wichmann; S Reif; A Potzel; V Dauber; C Schendell; N N Sommer; B Wolfarth; J Seissler; A Lechner; U Ferrari

doi:10.1371/journal.pone.0179128

Physical fitness and plasma leptin in women with recent gestational diabetes

PLoS One. 2017 Jun 13;12(6):e0179128. doi: 10.1371/journal.pone.0179128. eCollection 2017.

Authors

C Gar^{1

2

3}, M Rottenkolber^{1

2

3}, H Grallert², F Banning^{1

2

3}, I Freibothe^{1

2

3}, V Sacco^{1

2

3}, C Wichmann^{1

2

3}, S Reif^{1

2

3}, A Potzel^{1

2

3}, V Dauber^{1

2

3}, C Schendell^{1

2

3}, N N Sommer⁴, B Wolfarth⁵, J Seissler^{1

2

3}, A Lechner^{1

2

3}, U Ferrari^{1

2

3}

Affiliations

¹ Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany.
² CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany.
³ Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany.
⁴ Institut für klinische Radiologie, Klinikum der Universitaet Muenchen, Munich, Germany.
⁵ Humboldt Universitaet/Charité, Universitaetsmedizin Berlin, Abteilung Sportmedizin, Berlin, Germany.

Abstract

Aims/hypothesis: Low physical fitness (PF) is a risk factor for type 2 diabetes mellitus (T2D). Women with a history of gestational diabetes (GDM) are at risk for T2D at a young age, but the role of PF in this population is not clear. PF has also been found to correlate inversely with plasma leptin in previous studies. Here, we examine whether women who had GDM have lower PF than women after a normoglycemic pregnancy and, second, whether PF is associated with plasma leptin, independently of body fat mass.

Methods: Cross-sectional analysis of 236 participants in the PPSDiab Study (cohort study of women 3-16 months after delivery, 152 after gestational diabetes (pGDM), 84 after normoglycemic pregnancy (control subjects); consecutively recruited 2011-16); medical history, physical examination with bioelectrical impedance analysis (BIA), whole body magnetic resonance imaging (MRI) (n = 154), 5-point oral glucose tolerance test, cardiopulmonary exercise testing, clinical chemistry including fasting plasma leptin; statistical analysis with Mann-Whitney U and t -test, Spearman correlation coefficient, multiple linear regression.

Results: Women pGDM had lower maximally achieved oxygen uptake (VO2peak/kg: 25.7(21.3-29.9) vs. 30.0(26.6-34.1)ml/min/kg; total VO2peak: 1733(1552-2005) vs. 1970(1767-2238)ml/min; p<0.0001 for both), and maximum workload (122.5(105.5-136.5) vs. 141.0(128.5-159.5)W; p<0.0001). Fasting plasma leptin correlated inversely with PF (VO2peak/kg ρ = -0.72 p<0.0001; VO2peak ρ = -0.16 p = 0.015; max. load ρ = -0.35 p<0.0001). These associations remained significant with adjustment for body mass index, or for body fat mass (BIA and MRI).

Conclusions/interpretation: Women with a recent history of GDM were less fit than control subjects. Low PF may therefore contribute to the risk for T2D after GDM. This should be tested in intervention studies. Low PF also associated with increased leptin levels-independently of body fat. PF may therefore influence leptin levels and signaling. This hypothesis requires further investigation.

Publication types

Observational Study

MeSH terms

Adult
Blood Glucose / metabolism
Body Mass Index
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / blood
Diabetes, Gestational / blood*
Diabetes, Gestational / physiopathology*
Female
Glucose Tolerance Test
Humans
Leptin / blood*
Linear Models
Oxygen Consumption
Physical Fitness / physiology*
Pregnancy
Prospective Studies
Risk Factors

Substances

Blood Glucose
Leptin

Grants and funding

PD Dr. Andreas Lechner was supported by the Helmholtz Zentrum München, Klinikum der Universität München, and the German Center for Diabetes Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.