Soluble Leptin Receptor and Risk of Gestational Diabetes in a Multiethnic Population: A Prospective Cohort Study.

Abstract

Soluble leptin receptor (sOb-R), a potential marker of leptin resistance, is inversely associated with risk of type 2 diabetes, independently of leptin concentrations. We have previously shown that ethnic difference in leptin concentration may partly explain the increased risk of gestational diabetes (GDM) in South Asians. Our objective was to investigate whether sOb-R concentrations are associated with risk of GDM, whether concentrations of sOb-R differ across ethnic groups, and whether ethnic differences in sOb-R explain the ethnic differences in GDM risk. The STORK Groruddalen study; a prospective cohort study of pregnant women living in Oslo, Norway, between May 2008 and May 2010. Of the total sample (n = 823), 680 (47.1% Europeans) had sOb-R measured in pregnancy week 15 and an oral glucose tolerance test performed in week 28. GDM was diagnosed according to World Health Organization 2013 criteria. sOb-R was inversely associated with GDM (odds ratio, 0.76 [95% confidence interval, 0.69-0.83] per ng/ml increase in sOb-R, P < .001) in crude analysis. The association was attenuated after adjustments for covariates and leptin (0.85 [0.77-0.95], P = .004). Compared to women with sOb-R higher than 5 ng/ml, the odds ratio of GDM was 0.29(0.11-0.78; P = .014) among women with sOb-R greater than 10 ng/ml and 0.59 (0.37-0.94; P = .026) among women with sOb-R 5-10 ng/ml, in adjusted analysis. sOb-R levels did not differ across ethnic groups, and sOb-R did not explain ethnic differences in GDM risk. There was an independent, inverse association between sOb-R and GDM, with the lowest risk of GDM observed among higher sOb-R concentrations.