Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes

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Huvinen , E , Lahti , J , Klemetti , M M , Bergman , P H , Räikkönen , K , Orho-Melander , M , Laivuori , H & Koivusalo , S B 2022 , ' Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes ' , Diabetologia , vol. 65 , no. 8 , pp. 1291-1301 . https://doi.org/10.1007/s00125-022-05712-7

Title: Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes
Author: Huvinen, Emilia; Lahti, Jari; Klemetti, Miira M.; Bergman, Paula H.; Räikkönen, Katri; Orho-Melander, Marju; Laivuori, Hannele; Koivusalo, Saila B.
Contributor organization: Clinicum
HUS Gynecology and Obstetrics
Department of Obstetrics and Gynecology
University of Helsinki
Department of Psychology and Logopedics
Department of Public Health
Genomics of Neurological and Neuropsychiatric Disorders
Institute for Molecular Medicine Finland
Department of Medical and Clinical Genetics
Date: 2022-08
Language: eng
Number of pages: 11
Belongs to series: Diabetologia
ISSN: 0012-186X
DOI: https://doi.org/10.1007/s00125-022-05712-7
URI: http://hdl.handle.net/10138/346624
Abstract: Aims/hypothesis The aim of this study was to assess the interaction between genetic risk and lifestyle intervention on the occurrence of gestational diabetes mellitus (GDM) and postpartum diabetes. Methods The RADIEL study is an RCT aimed at prevention of GDM and postpartum diabetes through lifestyle intervention. Participants with a BMI >= 30 kg/m(2) and/or prior GDM were allocated to intervention and control groups before pregnancy or in early pregnancy. The study visits took place every 3 months before pregnancy, once in each trimester, and at 6 weeks and 6 and 12 months postpartum. We calculated a polygenic risk score (PRS) based on 50 risk variants for type 2 diabetes. Results Altogether, 516 participants provided genetic and GDM data. The PRS was associated with higher glycaemic levels (fasting glucose and/or HbA(1c)) and a lower insulin secretion index in the second and third trimesters and at 12 months postpartum, as well as with a higher occurrence of GDM and glycaemic abnormalities at 12 months postpartum (n = 356). There was an interaction between the PRS and lifestyle intervention (p=0.016 during pregnancy and p=0.024 postpartum) when analysing participants who did not have GDM at the first study visit during pregnancy (n = 386). When analysing women in tertiles according to the PRS, the intervention was effective in reducing the age-adjusted occurrence of GDM only among those with the highest genetic risk (OR 0.37; 95% CI 0.17, 0.82). The risk of glycaemic abnormalities at 12 months postpartum was reduced in the same group after adjusting additionally for BMI, parity, smoking and education (OR 0.35; 95% CI 0.13, 0.97). Conclusions/interpretation Genetic predisposition to diabetes modifies the response to a lifestyle intervention aimed at prevention of GDM and postpartum diabetes. This suggests that lifestyle intervention may benefit from being tailored according to genetic risk.
Subject: Diet
Gene-environment interaction
Genetic risk
Gestational diabetes
Lifestyle intervention
Physical activity
Polygenic risk score
Prevention
Type 2 diabetes
GLUCOSE
WOMEN
PROGRESSION
VARIANTS
SCORE
POLYMORPHISMS
ASSOCIATION
CONVERSION
METFORMIN
MELLITUS
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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