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Maternal rates of lipolysis and glucose production in late pregnancy are independently related to foetal weight
Author(s) -
Diderholm Barbro,
Beardsall Kathryn,
Murgatroyd Peter,
Lees Christoph,
Gustafsson Jan,
Dunger David
Publication year - 2017
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13359
Subject(s) - lipolysis , medicine , endocrinology , gestation , weight gain , gestational diabetes , pregnancy , respiratory quotient , biology , adipose tissue , body weight , genetics
Summary Objective Associations between maternal glucose levels and increased foetal growth are well established, and independent relationships with maternal weight, weight gain and insulin resistance are also observed. The relative roles of lipolysis and glucose production in the determination of these observations remain unclear. Design We examined, through detailed physiological studies, the relationship between maternal late gestational energy substrate production (glucose and glycerol), maternal weight and weight gain, and estimated foetal size in the third trimester. Patients Twenty‐one nulliparous pregnant women, without gestational diabetes ( GDM ) assessed at 28 weeks with oral glucose tolerance test, were recruited. Measurements Rates of hepatic glucose production ( GPR ) and rates of glycerol production (reflecting lipolysis) using [ 13 C 6 ]‐glucose and [ 2 H 5 ]‐glycerol were measured at 34‐36 weeks of gestation. Respiratory quotient was assessed by indirect calorimetry and body composition by measurements of total body water (TBW; H 2 18 O) and body density ( BODPOD ). Foetal weight was estimated from ultrasound measures of biparietal diameter, femoral length and abdominal circumference. Results At 34‐36 weeks, bivariate analyses showed that GPR and lipolysis correlated with estimated foetal weight ( r =.71 and .72, respectively) as well as with maternal weight, fat mass and fat‐free mass, but not maternal weight gain. In multivariate analyses, rates of both glucose production ( r =.42) and lipolysis ( r =.47) were independently associated with foetal size explaining 63% of the variance. Conclusions Both maternal rates of lipolysis and hepatic glucose production in late gestation are strongly related to estimated foetal weight.