Glucose Metabolism in Pregnancy at High Altitude
Open accessAbstract
OBJECTIVE—To assess insulin sensitivity and β-cell function associated with lower maternal fasting plasma glucose levels at high altitude compared with sea level. RESEARCH DESIGN AND METHODS—We studied 215 pregnant women at 8–42 weeks of gestation in Peru. The women were recruited from Cerro de Pasco, which is situated 4,370 m (14,340 feet) above sea level, and Lima, which is at sea level. We also examined 53 nonpregnant control subjects (22 in Cerro de Pasco and 31 in Lima). Fasting plasma glucose, insulin, C-peptide, and proinsulin concentrations were measured in samples obtained from the antecubital vein between 8:00 a.m. and 10:00 a.m. after an overnight period of fasting for 10–14 h. Insulin resistance and β-cell function were calculated using homeostasis model assessment. RESULTS—Fasting C-peptide levels and β-cell function were similar, fasting concentrations of insulin and proinsulin were lower, and insulin sensitivity was higher at high altitude compared with sea level. CONCLUSIONS—Maternal fasting plasma glucose that is lower at high altitude than at sea level in the presence of similar insulin secretion is associated with higher peripheral insulin sensitivity. This may partly explain the lower birth weights at high altitudes.
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The normal pregnancy-induced increase in maternal insulin resistance associated with increased placental production of somatotrophic and steroid hormones is absent in women chronically hypoxic at high altitude.
“Certainly, the normal pregnancy-induced increase in maternal insulin resistance associated with increased placental production of somatotrophic and steroid hormones is absent in women chronically hypoxic at high altitude (316).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [316]
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Cites
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Banting lecture 1980: of pregnancy and progeny.
Freinkel, N. (1980) · Diabetes · doi:10.2337/diab.29.12.1023 · Cited by 1,366 · see citing works
Banting Lecture 1980. Of pregnancy and progeny
Freinkel, N. (1980) · Diabetes · doi:10.2337/diabetes.29.12.1023 · Cited by 1,366 · see citing works
Jensen, G. M., & MOORE, L. G. (1997) · American Journal of Public Health · doi:10.2105/ajph.87.6.1003 · Cited by 355 · see citing works
Increased dependence on blood glucose after acclimatization to 4,300 m
Brooks, G. A., Butterfield, G. E., Wolfe, R. R., Groves, B. Μ., Mazzeo, R. S., Sutton, J. R., Wolfel, E. E., & Reeves, J. Τ. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.70.2.919 · Cited by 270 · see citing works
Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes
Hermans, M. P., Lévy, J., Morris, R. J., & Turner, R. C. (1999) · Diabetologia · doi:10.1007/s001250051215 · Cited by 260 · see citing works
Maternal physiologic adaptations to early human pregnancy
Clapp, J. F., Seaward, B. L., SLEAMAKER, R. H., & Hiser, J. (1988) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(88)90574-1 · Cited by 224 · see citing works
Kahn, S. E., & Halban, P. A. (1997) · Diabetes · doi:10.2337/diab.46.11.1725 · Cited by 221 · see citing works
Kahn, S. E., & Halban, P. A. (1997) · Diabetes · doi:10.2337/diabetes.46.11.1725 · Cited by 221 · see citing works
Kautzky‐Willer, A., Prager, R., Waldhäusl, W. K., Pacini, G., Thomaseth, K., Wagner, O. F., Ulm, M. R., Streli, C., & Ludvik, B. H. (1997) · Diabetes Care · doi:10.2337/diacare.20.11.1717 · Cited by 210 · see citing works
Blood glucose and oxygen tension levels in small-for-gestational-age fetuses
Economides, D. L., & Nicolaides, K. H. (1989) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(89)90453-5 · Cited by 208 · see citing works
Self-citationMills, J. L., Jovanovic, L., Knopp, R., Aarons, J., Conley, M., Park, E., Lee, Y. J., Holmes, L., Simpson, J. L., & Metzger, B. (1998) · Metabolism · doi:10.1016/s0026-0495(98)90290-6 · Cited by 199 · see citing works
Catalano, P. M., Tyzbir, E. D., Wolfe, R. R., Roman, N. M., B. Amini, S., & Sims, E. A. H. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(12)80011-1 · Cited by 194 · see citing works
Louie, R. F., Tang, Z., Sutton, D. V., Lee, J. H., & Kost, G. J. (2000) · Archives of Pathology & Laboratory Medicine · doi:10.5858/2000-124-0257-pocgt · Cited by 178 · see citing works
Maternal carbohydrate metabolism and its relationship fetal growth and body composition
Catalano, P. M., Drago, N. M., & Amini, S. B. (1995) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(95)90479-4 · Cited by 153 · see citing works
C-Peptide Measurement: Methods and Clinical Utility
Bonser, A. M., Garcia‐Webb, P., & Harrison, L. C. (1984) · CRC Critical Reviews in Clinical Laboratory Sciences · doi:10.3109/10408368409165766 · Cited by 151 · see citing works
Women at altitude: carbohydrate utilization during exercise at 4,300 m
Braun, B., Mawson, J. T., Muza, S. R., Dominick, S. B., Brooks, G. A., Horning, M. A., Rock, P. B., MOORE, L. G., Mazzeo, R. S., Ezeji-Okoye, S. C., et al. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.88.1.246 · Cited by 130 · see citing works
Fetal biometry at 4300 m compared to sea level in Peru
Krampl, E., LEES, C. C., Bland, M., Dorado, J. E., Moscoso, G. J., & Campbell, S. C. (2000) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.2000.00156.x · Cited by 128 · see citing works
Self-citation(1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(12)91207-7 · Cited by 120 · see citing works
Carbohydrate utilization during exercise after high-altitude acclimation: A new perspective
McClelland, G. B., Hochachka, P. W., & Weber, J. (1998) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.95.17.10288 · Cited by 114 · see citing works
Maternal hypoxic ventilatory response, ventilation, and infant birth weight at 4,300 m
MOORE, L. G., Brodeur, P., Chumbe, O., D'Brot, J., Hofmeister, S. E., & Monge, C. (1986) · Journal of Applied Physiology · doi:10.1152/jappl.1986.60.4.1401 · Cited by 99 · see citing works
Tang, Z., Du, X., Louie, R. F., & Kost, G. J. (2000) · Archives of Pathology & Laboratory Medicine · doi:10.5858/2000-124-0577-eopogm · Cited by 92 · see citing works
Kalkhoff, R. K., Richardson, B. L., & Beck, P. A. (1969) · Diabetes · doi:10.2337/diab.18.3.153 · Cited by 89 · see citing works
High field electrical conduction and breakdown in silicon incorporated polyethylene films
Liu, D., Kan, L., & Kao, K. C. (1991) · Journal of Applied Physics · doi:10.1063/1.349599 · Cited by 86 · see citing works
CARBOHYDRATE METABOLISM IN PREGNANCY. I. THE METABOLISM OF INSULIN BY HUMAN PLACENTAL TISSUE*†
Freinkel, N., & Goodner, C. J. (1960) · Journal of Clinical Investigation · doi:10.1172/jci104010 · Cited by 78 · see citing works
Blood volume expansion, preeclampsia, and infant birth weight at high altitude
Zamudio, S., Palmer, S. K., Dahms, T. E., Berman, J. C., McCullough, R. G., McCullough, R. E., & MOORE, L. G. (1993) · Journal of Applied Physiology · doi:10.1152/jappl.1993.75.4.1566 · Cited by 74 · see citing works
Ali, K. Z. M. (1997) · Placenta · doi:10.1016/s0143-4004(97)80046-x · Cited by 42 · see citing works
Stability of Plasma Glucose during Storage
Clark, M. L., Humphreys, S. M., & Frayn, K. N. (1990) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456329002700415 · Cited by 34 · see citing works
Maternal plasma glucose at high altitude
Krampl, E., Kametas, N. A., Cacho, A. M., Roden, M., & Nicolaides, K. H. (2001) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2001.00072.x · Cited by 25 · see citing works
Self-citationLiver function and blood flow at high altitude.
Ramsøe, K., Jarnum, S., Preisig, R., et al. (1970) · Journal of Applied Physiology · doi:10.1152/jappl.1970.28.6.725 · Cited by 24 · see citing works
Metzger, B. E., Rodeck, C. H., Freinkel, N., Price, J., & Young, M. (1985) · Placenta · doi:10.1016/s0143-4004(85)80044-8 · Cited by 13 · see citing works
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Placental Origins of Chronic Disease
Burton, G. J., Fowden, A. L., & Thornburg, K. L. (2016) · Physiological Reviews · doi:10.1152/physrev.00029.2015 · Cited by 717 · see citing works
Zamudio, S. (2003) · High Altitude Medicine & Biology · doi:10.1089/152702903322022785 · Cited by 161 · see citing works
Hypoglycemia and the Origin of Hypoxia-Induced Reduction in Human Fetal Growth
Zamudio, S., Torricos, T., Fik, E., Oyala, M., Echalar, L., Pullockaran, J., Tutino, E., Martin, B., Belliappa, S., Balanza, E., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0008551 · Cited by 141 · see citing works
Effects of chronic hypoxia in vivo on the expression of human placental glucose transporters
Zamudio, S., Baumann, M. U., & Illsley, N. P. (2006) · Placenta · doi:10.1016/j.placenta.2004.12.010 · Cited by 114 · see citing works
- Authors
- Krampl, E., Kametas, N. A., Nowotny, P., Roden, M., & Nicolaides, K. H.
- Affiliations
- Harris Birthright Research Centre for Fetal Medicine (GB)
- Harris Birthright Research Center for Fetal Medicine, King’s College Hospital, London, U.K.
- University of Vienna (AT)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-05-01
- Volume
- 24
- Issue
- 5
- Pages
- 817-822
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2067814203
- Cited by
- 41
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 2 · 2013: 1
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Update notices
- correction (2001-07-01)
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Fetal Medicine Foundation (1 037 116)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- high altitude, pregnancy, glucose metabolism, insulin sensitivity, beta-cell function, fasting blood glucose, C-peptide, proinsulin, insulin resistance, birth weight, maternal hyperglycemia
- MeSH terms
- Insulin Secretion, Altitude, Blood Glucose, C-Peptide, Cross-Sectional Studies, Female, Gestational Age, Humans, Insulin, Islets of Langerhans, Peru, Pregnancy, Proinsulin, Regression Analysis, Body Mass Index
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