Journal of Kerman University of Medical Sciences

Is Nutritional Status Associated with Quantitative Insulin Sensitivity Check Index in the First Trimester of Gestation?

Document Type : Original Article

Authors

Mohammad Amin Atazadegan 1
Maryam Yazdi 2
Azam Biabanaki-goortani 3
masoomeh goodarzi-khoigani 2

1 Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

3 Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.34172/jkmu.2024.42
Abstract
Background: As pregnancy progresses, insulin sensitivity (SI) might slowly decrease to 50% of the average value, which could result in gestational diabetes. As weight gain is associated with reduced SI and vice versa, we evaluated the possible correlation between nutritional status and SI, especially in early pregnancy.
Methods: This cross-sectional study was conducted on 138 healthy primiparous women between 6 and 10 weeks of gestation. By using a researcher-made questionnaire, the characteristics of the participants were gathered. A digital scale was used to measure participants’ weights. Nutrient intake was estimated based on the 72-hour dietary recall by Nutritionist 4 software. We used the pregnancy physical activity scale to estimate physical activity. In addition, fasting plasma glucose (FPG) and insulin values were included in the relevant formula to calculate the quantitative index of SI.
Results: After adjusting for significant maternal characteristics, the quantitative insulin sensitivity check index (QUICKI) in the first trimester was correlated with participants’ weight and household income. Furthermore, the QUICKI index had a significant inverse relationship with saturated and polyunsaturated fatty acids (PUFAs) intake while total fat intake was positively correlated. Also, consuming vitamin C, glucose, fructose, sugar, and carbohydrates increased the QUICKI index, while vitamin E intake decreased it.
Conclusion: The results showed that weight management may prevent gestational diabetes mellitus (GDM) during the first trimester. Moreover, the significant correlation between the above-mentioned nutrients and household income with the QUICKI index can be further examined in future studies.

Keywords

Insulin sensitivity
Nutrient intake
Macronutrient intake
Micronutrient intake
Pregnancy
Subjects
  1. Sonagra AD, Biradar SM, K D, Murthy DSJ. Normal pregnancya state of insulin resistance. J Clin Diagn Res. 2014;8(11):CC01- 3. doi: 10.7860/jcdr/2014/10068.5081.
  2. Sivan E, Homko CJ, Chen X, Reece EA, Boden G. Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes. 1999;48(4):834-8. doi: 10.2337/diabetes.48.4.834.
  3. Ismail NA, Aris NM, Mahdy ZA, Ahmad S, Naim NM, Siraj HH, et al. Gestational diabetes mellitus in primigravidae: a mild disease. Acta Medica (Hradec Kralove). 2011;54(1):21-4. doi: 10.14712/18059694.2016.12.
  4. Lacroix M, Battista MC, Doyon M, Houde G, Ménard J, Ardilouze JL, et al. Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol. 2014;51(4):609-16. doi: 10.1007/ s00592-014-0564-4.
  5. Allman BR, Andres A, Børsheim E. The association of maternal protein intake during pregnancy in humans with maternal and offspring insulin sensitivity measures. Curr Dev Nutr. 2019;3(6):nzz055. doi: 10.1093/cdn/nzz055.
  6. Allman BR, Diaz Fuentes E, Williams DK, Turner DE, Andres A, Børsheim E. Obesity status affects the relationship between protein intake and insulin sensitivity in late pregnancy. Nutrients. 2019;11(9):2190. doi: 10.3390/nu11092190.
  7. Radesky JS, Oken E, Rifas-Shiman SL, Kleinman KP, RichEdwards JW, Gillman MW. Diet during early pregnancy and development of gestational diabetes. Paediatr Perinat Epidemiol. 2008;22(1):47-59. doi: 10.1111/j.1365- 3016.2007.00899.x.
  8. Newsholme P, Cruzat V, Arfuso F, Keane K. Nutrient regulation of insulin secretion and action. J Endocrinol. 2014;221(3):R105-20. doi: 10.1530/joe-13-0616.
  9. Mazloomy Mahmoodabad SS, Molavi S, Nadjarzadeh A, Mardanian F, Riahi R, Ardian N, et al. Prevention of postpartum weight retention during one year after childbirth by prenatal nutrition education: a randomized controlled trial. Int J Prev Med. 2021;12:117. doi: 10.4103/ijpvm.IJPVM_37_20.
  10. Mardanian F, Goodarzi-Khoigani M, Mazloomy Mahmoodabad SS, Baghiani Moghadam MH, Nadjarzadeh A, Feizi A, et al. The association between serum TSH concentration whithin the normal range and nutritional status in euthyroid pregnant women at the first trimester of gestation. J Res Med Sci. 2021;26:93. doi: 10.4103/jrms.JRMS_780_20.
  11. Fathnezhad Kazemi A, Hajian S, Sharifi N. The psychometric properties of the Persian version of the pregnancy physical activity questionnaire. Int J Womens Health Reprod Sci. 2019;7(1):54-60. doi: 10.15296/ijwhr.2019.09.
  12. Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402-10. doi: 10.1210/ jcem.85.7.6661.
  13. Bandres-Meriz J, Dieberger AM, Hoch D, Pöchlauer C, Bachbauer M, Glasner A, et al. Maternal obesity affects the glucose-insulin axis during the first trimester of human pregnancy. Front Endocrinol (Lausanne). 2020;11:566673. doi: 10.3389/fendo.2020.566673.
  14. Demir AK, Şahin Ş, Kaya SU, Bütün İ, Çıtıl R, Önder Y, et al. Prevalence of insulin resistance and identifying HOMA1-IR and HOMA2-IR indexes in the Middle Black Sea region of Turkey. Afr Health Sci. 2020;20(1):277-86. doi: 10.4314/ahs. v20i1.33.
  15. Yang MH, Hall SA, Piccolo RS, Maserejian NN, McKinlay JB. Do behavioral risk factors for prediabetes and insulin resistance differ across the socioeconomic gradient? Results from a community-based epidemiologic survey. Int J Endocrinol. 2015;2015:806257. doi: 10.1155/2015/806257.
  16. Volaco A, Cavalcanti AM, Filho RP, Précoma DB. Socioeconomic status: the missing link between obesity and diabetes mellitus? Curr Diabetes Rev. 2018;14(4):321-6. doi: 10.2174/1573399813666170621123227.
  17. Aloia CR, Gasevic D, Yusuf S, Teo K, Chockalingam A, Patro BK, et al. Differences in perceptions and fast food eating behaviours between Indians living in high- and low-income neighbourhoods of Chandigarh, India. Nutr J. 2013;12:4. doi: 10.1186/1475-2891-12-4.
  18. Lee JS, Pinnamaneni SK, Eo SJ, Cho IH, Pyo JH, Kim CK, et al. Saturated, but not n-6 polyunsaturated, fatty acids induce insulin resistance: role of intramuscular accumulation of lipid metabolites. J Appl Physiol (1985). 2006;100(5):1467-74. doi: 10.1152/japplphysiol.01438.2005 .
  19. Yu C, Chen Y, Cline GW, Zhang D, Zong H, Wang Y, et al. Mechanism by which fatty acids inhibit insulin activation of insulin receptor substrate-1 (IRS-1)-associated phosphatidylinositol 3-kinase activity in muscle. J Biol Chem. 2002;277(52):50230-6. doi: 10.1074/jbc.M200958200.
  20. Noakes TD, Windt J. Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review. Br J Sports Med. 2017;51(2):133-9. doi: 10.1136/bjsports-2016-096491.
  21. Yang Q, Vijayakumar A, Kahn BB. Metabolites as regulators of insulin sensitivity and metabolism. Nat Rev Mol Cell Biol. 2018;19(10):654-72. doi: 10.1038/s41580-018-0044-8.
  22. Chen X, Scholl TO, Leskiw MJ, Donaldson MR, Stein TP. Association of glutathione peroxidase activity with insulin resistance and dietary fat intake during normal pregnancy. J Clin Endocrinol Metab. 2003;88(12):5963-8. doi: 10.1210/ jc.2003-030544.
  23. Schwingshackl L, Hoffmann G. Monounsaturated fatty acids, olive oil and health status: a systematic review and metaanalysis of cohort studies. Lipids Health Dis. 2014;13:154. doi: 10.1186/1476-511x-13-154.
  24. Straczkowski M, Kowalska I, Nikolajuk A, DzienisStraczkowska S, Kinalska I, Baranowski M, et al. Relationship between insulin sensitivity and sphingomyelin signaling pathway in human skeletal muscle. Diabetes. 2004;53(5):1215- 21. doi: 10.2337/diabetes.53.5.1215.
  25. Khodaeian M, Tabatabaei‐Malazy O, Qorbani M, Farzadfar F, Amini P, Larijani B. Effect of vitamins C and E on insulin resistance in diabetes: a meta‐analysis study. Eur J Clin Invest. 2015;45(11):1161-74. doi: 10.1111/eci.12534.
  26. Sanchez-Lugo L, Mayer-Davis EJ, Howard G, Selby JV, Ayad MF, Rewers M, et al. Insulin sensitivity and intake of vitamins E and C in African American, Hispanic, and non-Hispanic white men and women: the Insulin Resistance and Atherosclerosis Study (IRAS). Am J Clin Nutr. 1997;66(5):1224-31. doi: 10.1093/ajcn/66.5.1224.
  27. Hyder M, Raja D, Varma V, Ponnusankar S. Oxidative stress during insulin resistance in prediabetes: a review on role of antioxidants. Int J Res Pharm Sci. 2020;11(3):3511-20. doi: 10.26452/ijrps.v11i3.2503.
  28. Gregório BM, De Souza DB, de Morais Nascimento FA, Pereira LM, Fernandes-Santos C. The potential role of antioxidants in metabolic syndrome. Curr Pharm Des. 2016;22(7):859-69. doi: 10.2174/1381612822666151209152352.
  29. Ahmadi-Abhari S, Luben RN, Powell N, Bhaniani A, Chowdhury R, Wareham NJ, et al. Dietary intake of carbohydrates and risk of type 2 diabetes: the European Prospective Investigation into Cancer-Norfolk study. Br J Nutr. 2014;111(2):342-52. doi: 10.1017/s0007114513002298.
  30. Lecoultre V, Egli L, Carrel G, Theytaz F, Kreis R, Schneiter P, et al. Effects of fructose and glucose overfeeding on hepatic insulin sensitivity and intrahepatic lipids in healthy humans. Obesity (Silver Spring). 2013;21(4):782-5. doi: 10.1002/ oby.20377.
  31. Johnson HM, Stanfield E, Campbell GJ, Eberl EE, Cooney GJ, Bell-Anderson KS. Glucose mediates insulin sensitivity via a hepatoportal mechanism in high-fat-fed rats. J Endocrinol. 2019;241(3):189-99. doi: 10.1530/joe-18-0566.
Journal of Kerman University of Medical Sciences
Volume 31, Issue 5
September and October 2024
Pages 272-277

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