Association of circulating galectin‐3 with gestational diabetes mellitus, progesterone, and insulin resistance
Zeqing Zhang, Xuehui Kang, Yaming Guo, Jianhua Zhang, Junhui Xie, Shiying Shao, Ying Xiang, Gang Chen, Xuefeng Yu
Abstract
BACKGROUND/OBJECTIVE: Because galectin-3 has been proposed to regulate obesity and insulin resistance in mice, we hypothesized that circulating galectin-3 levels are associated with presence of gestational diabetes mellitus (GDM), progesterone, and insulin resistance. METHODS: Circulating galectin-3 levels were measured using an enzyme-linked immunosorbent assay (ELISA) in women with GDM (n = 137) and their controls (n = 81). Associations of galectin-3 and progesterone with GDM and insulin resistance were evaluated using regression models. RESULTS: Circulating galectin-3 levels were increased in the individuals with GDM (P < .001) and associated significantly with progesterone (r = 0.42, P < .001), gestational age at sampling (r = 0.23, P < .001), current body mass index (BMI; r = 0.17, P = .02), estrogen (r = 0.15, P < .03), fasting glucose (r = 0.41, P < .001), fasting insulin (r = 0.39, P < .001), and homeostasis model assessment of insulin resistance (HOMA-IR; r = 0.44, P < .001). After adjustment for potential confounders, including current BMI, subjects in the highest tertile of galectin-3 levels were more likely to have GDM (odds ratio 4.71, 95% confidence interval 2.01-11.06) as compared with the lowest tertile. The association between circulating galectin-3 levels and GDM remained significant after adjusting for progesterone, but significantly attenuated after adjustment with HOMA-IR. Furthermore, the multiple linear regression analyses after adjustment for confounders showed an independent association between galectin-3 levels and HOMA-IR (β = .41, P < .001), suggesting that association of circulating gelactin-3 levels with GDM might be mediated via insulin resistance. Progesterone demonstrated the expected associations with galectin-3, GDM, and HOMA-IR. CONCLUSIONS: Circulating galectin-3 levels are associated with GDM possibly through increased insulin resistance. The association of galectin-3 with progesterone highlights a potential role of progesterone in its interaction with galectin-3.