Growth differentiation factor 15 levels in obese and healthy pregnancies
and its relation to insulin resistance and insulin secretory function: a
longitudinal study during and after pregnancy
Abstract
Objective/aim Growth-differentiation-factor 15 (GDF15) has been
suggested to improve or protect beta-cell function. During pregnancy,
beta-cell numbers and function increase to overcome the natural rise in
insulin resistance during gestation. In this study, we longitudinally
measured serum GDF15 levels during and after pregnancy in women of
normal weight (NW) and in women with obesity (OB) and explored
associations between GDF15 and changes in beta-cell function by
homeostatic model assessment (HOMA). Methods The cohort participants
were 38 NW (BMI 22.3±1.7) and 35 OB (BMI 35.8±4.2). Blood was sampled
and body composition measured at each trimester (T1, T2, and T3) and at
6, 12, and 18 months postpartum. Fasting glucose, insulin, and GDF15
were measured, and HOMA for insulin resistance (HOMA-IR) and beta cell
function (HOMA-B) determined. Results GDF15 levels increased
significantly each trimester and were ~200-fold higher
at T3 than in the nonpregnant postpartum state. GDF15 was higher in NW
than OB in T3, but was lower in NW at 18 months after pregnancy. GDF15
correlated inversely with BMI and fat-free mass at T3. Low GDF15 in T1
was associated with lower incidence of nausea and with carrying a male
fetus. GDF15 at T2 and T3 and the increases between trimesters
associated with increased HOMA-B over the course of pregnancy. Increases
in GDF15 either early or late in pregnancy were associated with a
reduction in blood glucose between T2 and T3. Conclusion Large
gestational upregulation of GDF15 levels may help increase insulin
secretory function to overcome pregnancy-induced insulin resistance.