734-P: High Pancreatic-Derived Factor Level Is Relative to a Lower Remission of Early Postpartum Impaired Glucose Tolerance in Women with History of Gestational Diabetes Mellitus

Abstract

Purpose: To clarify whether pancreatic derived factor (PANDER) predicted the remission of early postpartum impaired glucose tolerance (IGT) by lifestyle intervention among women with history of gestational diabetes mellitus (GDM). Methods: IGT women with GDM history in a prospective cohort study were enrolled at postpartum 4-12 weeks. Subjects were grouped based on quarters of PANDER level at recruitment. After lifestyle intervention, the oral glucose tolerance test (OGTT) was performed and insulin levels were measured at one year postpartum. The relation between PANDER and glycemic outcome was analyzed with logistic regression and receiver operating characteristic curve (ROC). Results: A total of 113 women were included. 55 (48.7%) of these IGT women were reversed to normal glucose tolerance at one year postpartum by lifestyle intervention. The odds of remission were lower in participants with high PANDER level than in those with low PANDER level. Compared those with PANDER<3.19ng/mL, women with PANDER>5.34 ng/mL, and PANDER>8.77ng/mL, were associated with a lower effect on remission of IGT (OR=0.31, 95%CI 0.11-0.90, P=0.031 and OR=0.12, 95%CI 0.04-0.41, P=0.001, respectively). After adjusting for other confounders, these associations remained in multivariable logistic regression. The area under the receiver operating characteristic curve (AUC) of PANDER for the remission of IGT was 0.702 (95% CI 0.595-0.809). When PANDER was combined with clinical information, the AUC reached 0.812 (95% CI 0.725-0.899) (P<0.001). Conclusions: High PANDER level in early postpartum was closely associated with the remission of IGT by lifestyle intervention in women with GDM history at one year postpartum. Disclosure L.Pei: None. F.Lai: None. W.Chen: None. N.Chen: None. R.Zeng: None. S.Yue: None. Z.Li: None. C.Wang: None. X.Cao: None. Funding Sun Yat-sen University (2017001); Science and Technology Foundation of Guangzhou City (201803010101)