Pregestational type 2 diabetes and gestational diabetes exhibit different sexual steroid profiles during pregnancy

Abstract

Higher androgen levels are observed in non-pregnant women with diabetes. Whether thishormonal profile is found during pregnancy is unknown. The aim of this study was todetermine the sexual steroids levels in pregnant women with pregestational type 2 (T2D) andgestational diabetes (GD) compared to healthy control (C) pregnant women during the secondhalf of pregnancy. A prospective study of 69 pregnant women with T2D (n¼21), GD (n¼24)and control (C,n¼24) was followed up during the second half of gestation. Clinicalassessments and blood samples were collected at 26.7 (25–27.8); 34 (32–34.9) and 37.5 (37–40)weeks of gestation. Androgens, sex hormone-binding globulin (SHBG), estrogens, estradiol/testosterone (E/T) ratio, insulin, glucose, HOMA-IR, were measured. Testosterone, insulin andhomeostatic model assessment of insulin resistance (HOMA-IR) levels were higher in T2Dcompared with C at each sampling point during pregnancy, even after adjusting for BMI andage. Estrogens levels and estradiol/testosterone ratio were lower in T2D and GD compared withC. Hyperandrogenemia, and higher insulin resistance is observed in T2D, but not in GD duringpregnancy. Decreased estrogen and E/T ratio found in T2D and GD suggests a diminishedaromatase activity during gestation. T2D and GD are associated with specific changes in sexualsteroids and insulin resistance levels during pregnancy.