HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 287/3/E472    most recent 00589.2003v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Okereke, N. C. Articles by Catalano, P. M. Search for Related Content PubMed PubMed Citation Articles by Okereke, N. C. Articles by Catalano, P. M.

Longitudinal changes in energy expenditure and body composition in obese women with normal and impaired glucose tolerance

Departments of ¹Reproductive Biology and ²Pediatrics and ³The Schwartz Center for Metabolism and Nutrition, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio 44109

Submitted 31 December 2003 ; accepted in final form 22 April 2004

Our primary objective was to evaluate changes in energy expenditure and body composition in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). A secondary objective was to examine the relationship between maternal leptin and nutrient metabolism. Fifteen obese women, eight with NGT and seven with GDM, were evaluated before conception (P), at 12–14 wk (E), and at 34–36 wk (L). Energy expenditure and glucose and fat metabolism were measured using indirect calorimetry. Basal hepatic glucose production was measured using [6,6-²H₂]glucose and insulin sensitivity by euglycemic clamp. There was a significant increase (6.6 kg, P = 0.0001) in fat mass from P to L. There was a 30% (P = 0.0001) increase in basal O₂ consumprion (O₂, ml/min). There were no significant changes in carbohydrate oxidation during fasting or storage from P to L. There was, however, a significant (P = 0.0001) 150% increase in basal fat oxidation (mg/min) from P to L. Under hyperinsulinemic conditions, there were similar 25% increases in O₂ (P = 0.0001) from P to L in both groups. Because of the significant increases in insulin resistance from P to L, there was a significant (P = 0.0001) decrease in carbohydrate oxidation and storage. There was a net change from lipogenesis to lipolysis, i.e., fat oxidation (30–40 mg/min, P = 0.0001) from P to L. Serum leptin concentrations had a significant positive correlation with fat oxidation at E (r = 0.76, P = 0.005) and L (r = 0.72, P = 0.009). Pregnancy in obese women is associated with significant increases in fat mass and basal metabolic rate and an increased reliance on lipids both in the basal state and during the clamp. These modifications are similar in women with NGT and GDM. The increased reliance on fat metabolism is accompanied by a concomitant decrease in carbohydrate metabolism during hyperinsulinemia. The increase in fat oxidation may be related to increased maternal serum leptin.

gestational diabetes; pregnancy; leptin

This article has been cited by other articles:

				F. H. Einstein, S. Fishman, R. H. Muzumdar, X. M. Yang, G. Atzmon, and N. Barzilai Accretion of visceral fat and hepatic insulin resistance in pregnant rats Am J Physiol Endocrinol Metab, February 1, 2008; 294(2): E451 - E455. [Abstract] [Full Text] [PDF]

				M. Lof, H. Olausson, K. Bostrom, B. Janerot-Sjoberg, A. Sohlstrom, and E. Forsum Changes in basal metabolic rate during pregnancy in relation to changes in body weight and composition, cardiac output, insulin-like growth factor I, and thyroid hormones and in relation to fetal growth Am. J. Clinical Nutrition, March 1, 2005; 81(3): 678 - 685. [Abstract] [Full Text] [PDF]