Pancreatic-derived factor predicts remission of impaired glucose tolerance women with history of gestational diabetes

Aim: To clarify whether pancreatic derived factor (PANDER) predicts the remission of impaired glucose tolerance (IGT) due to lifestyle intervention among women with history of gestational diabetes mellitus (GDM). Methods: IGT women with GDM history in a prospective cohort study were enrolled at 4-12 weeks postpartum and grouped based on PANDER level at recruitment. After lifestyle intervention, glucose metabolism examined was performed at one year postpartum. The relation between PANDER level and glycemic outcome was analyzed with logistic regression and receiver operating characteristic (ROC) curves. Results: In total, 48.7% (55/113) of subjects returned to normal glucose tolerance at one year postpartum. Compared to those with low PANDER group, women among high PANDER group and very high PANDER group were associated with a lower remission of IGT. These associations remained in multivariable logistic regression. The area under the ROC curve (AUC) of PANDER level for the remission of IGT was 0.702 (95% CI 0.595-0.809). When PANDER level was combined with clinical information, the AUC reached 0.812 (95% CI 0.725-0.899; P < 0.001). Conclusion: Circulating PANDER concentration is inversely associated with the remission of IGT in women with GMD history at one year postpartum.