The Relationship between the Nutritioun Status and Insulin Resistance Index in the First Trimester of Pregnancy

Document Type : Original Article (s)

Authors

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

2 Professor, Department of Health Education and Promotion, School of Public Health AND Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Professor, Department of Health, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran

4 Associate Professor, Nutrition and Food Security Research Center AND Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

6 Professor, Department of Statistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran

7 Assistant Professor, Department of Nursing, Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran

Abstract

Background: Progressive insulin resistance (IR) is a physiologic state during pregnancy which could be ended to gestational diabetes. Given the relationship between weight and insulin resistance (IR), the study of the association between nutrients intake and insulin resistance is particularly rational and predictive.Methods: The current descriptive cross-sectional study was performed on 138 nulliparous women with healthy and single pregnancies. Individual characteristics were collected by a researcher-administered questionnaire. At 6th-10th weeks of pregnancy, physical activity scores and nutrients intake were determined using the Pregnancy Physical Activity Questionnaire and 24-hour recall for three consecutive days, respectively. At the same time, fasting serum glucose and insulin levels were also measured to calculate IR by the formula.Findings: Square root transformation of IR index at the first trimester was significantly correlated with household income, occupational activity, pre-pregnancy body mass index (BMI), weight, and physical activity at 6th-10th weeks of gestation. However, after adjusting the effect of related variables, household income and maternal weight were significantly associated with IR, and occupational activity had a trend toward the significant association. Moreover, vitamin D, linolenic acid, beta-carotene, vitamin E, and carbohydrate intake were significantly correlated with IR index. However, after adjusting for the related variables, vitamin E had a direct significant relationship with IR, and glucose and maltose intakes were inversely associated with IR.Conclusion: Significant association between household income and maternal weight at the first trimester can be used to control IR, which is a key component for gestational diabetes. The association of vitamin E, glucose, and maltose intakes with IR may be a guide to get new results. We suggest further studies about the association between occupational activity and insulin resistance in pregnant women.

Keywords

References

  1. Catalano PM, Kirwan JP, Haugel-de MS, King J. Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus. J Nutr 2003; 133(5 Suppl 2): 1674S-83S.
  2. 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.
  3. Riskin-Mashiah S, Younes G, Damti A, Auslender R. First-trimester fasting hyperglycemia and adverse pregnancy outcomes. Diabetes Care 2009; 32(9): 1639-43.
  4. Dandona P, Ghanim H, Chaudhuri A, Dhindsa S, Kim SS. Macronutrient intake induces oxidative and inflammatory stress: Potential relevance to atherosclerosis and insulin resistance. Exp Mol Med 2010; 42(4): 245-53.
  5. Um SH, D'Alessio D, Thomas G. Nutrient overload, insulin resistance, and ribosomal protein S6 kinase 1, S6K1. Cell Metab 2006; 3(6): 393-402.
  6. Pollock NK, Bundy V, Kanto W, Davis CL, Bernard PJ, Zhu H, et al. Greater fructose consumption is associated with cardiometabolic risk markers and visceral adiposity in adolescents. J Nutr 2012; 142(2): 251-7.
  7. Ricci G, Canducci E, Pasini V, Rossi A, Bersani G, Ricci E, et al. Nutrient intake in Italian obese patients: relationships with insulin resistance and markers of non-alcoholic fatty liver disease. Nutrition 2011; 27(6): 672-6.
  8. McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 2004; 27(2): 538-46.
  9. Allman BR, Andres A, Borsheim 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.
  10. Goodarzi-Khoigani M, Baghiani Moghadam MH, Nadjarzadeh A, Mardanian F, Fallahzadeh H, Mazloomy-Mahmoodabad S. Impact of nutrition education in improving dietary pattern during pregnancy based on pender's health promotion model: a randomized clinical trial. Iran J Nurs Midwifery Res 2018; 23(1): 18-25.
  11. Moradian Sorkhkalaee M, Eftekhar Ardebili H, Nedjat S, Saiepour N. Social capital among medical Students of Tehran University of Medical Sciences in 2011. Razi J Med Sci 2012; 19 (102): 30-7. [In Persian].
  12. Fathnezhad Kazemi A, Hajian S, Sharifi N. The psychometric properties of the Farsi version of The Pregnancy Physical Activity Questionnaire. Int J Women's Health Reprod Sci 2019; 7(1): 54-60.
  13. Yang YJ, Kim MK, Hwang SH, Ahn Y, Shim JE, Kim DH. Relative validities of 3-day food records and the food frequency questionnaire. Nutr Res Pract 2010; 4(2): 142-8.
  14. Farias DR, Franco-Sena AB, Vilela A, Lepsch J, Mendes RH, Kac G. Lipid changes throughout pregnancy according to pre-pregnancy BMI: Results from a prospective cohort. BJOG 2016; 123(4): 570-8.
  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.
  16. Demir AK, Sahin S, Kaya SU, Butun I, Citil R, Onder 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.
  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.
  18. Imoh LC, Ocheke AN. Correlation between maternal weight and insulin resistance in second half of pregnancy. Niger Med J 2014; 55(6): 465-8.
  19. Ye J. Mechanisms of insulin resistance in obesity. Front Med 2013; 7(1): 14-24.
  20. Gradmark A, Pomeroy J, Renstrom F, Steiginga S, Persson M, Wright A, et al. Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth 2011; 11: 44.
  21. Esteghamati A, Khalilzadeh O, Rashidi A, Meysamie A, Haghazali M, Asgari F, et al. Association between physical activity and insulin resistance in Iranian adults: National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007). Prev Med 2009; 49(5): 402-6.
  22. Goncalves A, Amiot MJ. Fat-soluble micronutrients and metabolic syndrome. Curr Opin Clin Nutr Metab Care 2017; 20(6): 492-7.
  23. Rodriguez-Monforte M, Sanchez E, Barrio F, Costa B, Flores-Mateo G. Metabolic syndrome and dietary patterns: A systematic review and meta-analysis of observational studies. Eur J Nutr 2017; 56(3): 925-47.
  24. Ley SH, Hanley AJ, Sermer M, Zinman B, O'Connor DL. Lower dietary vitamin E intake during the second trimester is associated with insulin resistance and hyperglycemia later in pregnancy. Eur J Clin Nutr 2013; 67(11): 1154-6.
  25. 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.
  26. Daly M. Sugars, insulin sensitivity, and the postprandial state. Am J Clin Nutr 2003; 78(4): 865S-72S.
  27. Folchetti LD, Monfort-Pires M, de Barros CR, Martini LA, Ferreira SR. Association of fruits and vegetables consumption and related-vitamins with inflammatory and oxidative stress markers in prediabetic individuals. Diabetol Metab Syndr 2014; 6(1): 22.
  28. Liese AD, Schulz M, Fang F, Wolever TM, D'Agostino RB, Sparks KC, et al. Dietary glycemic index and glycemic load, carbohydrate and fiber intake, and measures of insulin sensitivity, secretion, and adiposity in the Insulin Resistance Atherosclerosis Study. Diabetes Care 2005; 28(12): 2832-8.
  29. Davis JN, Alexander KE, Ventura EE, Kelly LA, Lane CJ, Byrd-Williams CE, et al. Associations of dietary sugar and glycemic index with adiposity and insulin dynamics in overweight Latino youth. Am J Clin Nutr 2007; 86(5): 1331-8.
  30. Laube H, Wojcikowski C, Schatz H, Pfeiffer EF. The effect of high maltose and sucrose feeding on glucose tolerance. Horm Metab Res 1978; 10(3): 192-5.
  31. Qin LQ, Li J, Wang Y, Wang PY, Sato A, Kaneko T. Effect of repeated intake of disaccharides on glucose metabolism and insulin secretion in healthy adults - comparison between sucrose and maltose. J Health Sci 2003; 49(3): 226-8.
Journal of Isfahan Medical School
Volume 38, Issue 584 - Serial Number 584
May and June 2020
Pages 512-520

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History

  • Receive Date: 17 January 2020
  • Revise Date: 05 May 2024
  • Accept Date: 06 April 2022

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