C-reactive protein during pregnancy and in the early postpartum predicts adverse metabolic health outcomes at 1 year postpartum in women with gestational diabetes

Quansah, Dan Yedu; Horsch, Antje; Gilbert, Leah; Donath, Marc Y.; Puder, Jardena J.

doi:10.1186/s12933-023-02034-9

Cardiovascular Diabetology

Table 3 Cross-sectional associations between CRP and metabolic health outcomes during pregnancy and in the postpartum

From: C-reactive protein during pregnancy and in the early postpartum predicts adverse metabolic health outcomes at 1 year postpartum in women with gestational diabetes

Variable	Model 1			Model 2			Model 3
Variable	β	95% CI	p value	β	95% CI	p value	β	95% CI	p value
CRP at 28–32 weeks GA	Insulin resistance and secretion variables during pregnancy
Weight (kg)^bc	1.68	1.18, 2.17	< 0.001	1.67	1.2, 2.20	< 0.001	NA	NA	NA
Body fat (kg)^c	1.24	0.94, 1.55	< 0.001	0.28	0.15, 0.41	< 0.001	NA	NA	NA
MetS-BMI, yes^a	1.12	1.03, 1.22	0.006	1.02	0.90, 1.11	0.965	0.98	0.87, 1.09	0.772
Fasting glucose (mmol/l)	0.02	0.008, 0.04	0.004	0.02	0.009, 0.04	0.004	0.06	− 0.02, 0.02	0.995
HbA1c (%)	0.01	0.004, 0.02	0.007	0.01	0.007, 0.03	0.001	0.09	− 0.03, 0.02	0.164
HOMA-IR	0.16	0.05, 0.26	0.003	0.15	0.05, 0.26	0.004	0.002	-0.08, 0.09	0.960
HOMA-B	1.99	0.69, 3.2	0.003	0.21	− 1.06, 1.48	0.742	− 0.16	− 1.41, 1.01	0.792
CRP at 6–8 weeks pp	Insulin resistance and secretion variables at 6–8 weeks postpartum
Weight (kg)^bc	1.48	0.88, 2.09	< 0.001	1.48	0.87, 2.08	< 0.001	NA	NA	NA
Body fat (kg)^c	1.06	0.66, 1.45	< 0.001	0.16	0.03, 0.29	0.015	NA	NA	NA
MetS-BMI, yes^a	1.10	0.97, 1.25	0.107	0.98	0.83, 1.15	0.818	0.92	0.76, 1.11	0.421
Fasting glucose (mmol/l)	0.01	− 0.01, 0.04	0.228	− 0.005	− 0.03, 0.02	0.686	− 0.006	− 0.03, 0.02	0.665
HbA1c (%)	0.01	− 0.007, 0.03	0.060	0.02	0.0005, 0.36	0.043	0.01	0.001, 0.03	0.036
HOMA-IR	0.11	0.03, 0.19	0.005	0.04	− 0.03, 0.12	0.306	0.03	− 0.04, 0.11	0.383
MATSUDA index	− 0.38	− 0.56, − 0.19	< 0.001	− 0.19	− 0.37, − 0.02	0.024	− 0.18	− 0.35, − 0.01	0.038
ISSI-2	− 0.06	− 0.11, − 0.02	0.009	− 0.03	− 0.08, 0.02	0.226	− 0.03	− 0.08, 0.02	0.284
AUC_ins/glu	0.01	0.006, 0.03	0.002	0.09	− 0.007, 0.01	0.070	0.08	− 0.01, 0.02	0.106
HOMA-B	1.59	0.41, 2.76	0.008	0.57	− 0.57, 1.72	0.325	0.49	− 0.67, 1.65	0.409
CRP at 1-year pp	Insulin resistance and secretion variables at 1-year postpartum
Weight (kg)^bc	1.59	0.99, 2.19	< 0.001	1.58	0.98, 2.19	< 0.001	NA	NA	NA
Body fat (kg)^c	1.23	0.84, 1.61	< 0.001	0.25	0.13, 0.36	< 0.001	NA	NA	NA
MetS-BMI, yes^a	1.20	1.08, 1.33	< 0.001	1.12	0.98, 1.27	0.073	1.09	0.95, 1.24	0.198
MetS-WC, yes^a	1.15	1.05, 1.26	0.002	1.09	0.98, 1.21	0.098	1.07	0.96, 1.18	0.183
Fasting glucose (mmol/l)	0.02	0.003, 0.05	0.027	0.01	− 0.009, 0.04	0.211	0.02	− 0.01, 0.045	0.232
HbA1c (%)	0.002	− 0.02, 0.03	0.808	− 0.07	− 0.03, 0.02	0.546	− 0.01	− 0.04, 0.01	0.364
HOMA-IR	0.19	0.09, 0.28	< 0.001	0.05	− 0.03, 0.13	0.238	0.03	− 0.06, 0.12	0.546
MATSUDA index	− 0.24	− 0.36, − 0.12	< 0.001	− 0.07	− 0.18, 0.04	0.214	− 0.04	− 0.16, 0.07	0.439
ISSI-2	− 0.05	− 0.08, − 0.01	0.014	− 0.01	− 0.05, 0.02	0.547	− 0.07	− 0.49, 0.35	0.739
AUC_ins/glu	0.02	0.008, 0.03	0.001	0.07	0.03, 0.18	0.195	0.006	− 0.006, 0.01	0.322
HOMA-B	2.13	0.85, 3.40	0.001	0.20	− 0.95, 1.35	0.729	− 0.20	− 1.39, 0.97	0.726

CRP denotes C-reactive protein; GA denotes gestational age; MetS denote metabolic syndrome; BMI denotes Body Mass Index; Mets-WC denotes metabolic syndrome based on waist circumference; pp denotes postpartum; NA denoted not applicable; HbA1c denotes glycated hemoglobin; HOMA-IR denotes Homeostatic Model Assessment for Insulin Resistance; ISSI-2 denotes; Insulin Secretion-Sensitivity Index-2; AUCins/glu denotes Area under the Curve; HOMA-B denotes HOMA of b-cell index.
Model 1: Adjusted for group allocation. Model 2: Adjusted for group allocation, gestational age, age, previous history of GDM, family history of GDM, breastfeeding, weight at prediction time point. Model 3: adjusted for group allocation, gestational age, age, previous history of GDM, family history of GDM, breastfeeding, body fat at the prediction time point.
^aEstimates are from logistic regression analyses (Odds ratio and 95% CI). MetS-WC is not relevant in pregnancy and too early to assess in the early pp
For these variables, the associations were not adjusted for ^bweight or ^cbody fat (additionally adjusted for age).
Bold p-values indicate significant p-values

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