Poster Presentation ESA-SRB-APEG-NZSE 2022

Adiposity and other factors predicting recovery of bone density at 12 months post GDM pregnancy (#312)

Ernestene Yao 1 , Allison Sigmund 1 2 , Craig Coorey 1 , Mark Mclean 1 2 , Mawson Wang 3 , Sue Lynn Lau 1 2
  1. Western Sydney University, Campbelltown, NSW, Australia
  2. Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
  3. Concord Hospital, Concord, NSW, Australia

Gestational diabetes mellitus (GDM) represents an intersection between pregnancy and T2DM; both states impacting bone density (BMD) and structure. We aimed to identify factors influencing bone health after GDM pregnancy. In a longitudinal, observational study of women post-GDM, anthropometric measurements, biochemistry, DXA and lifestyle questionnaires were completed at 3 and 12 months postpartum. Data from 101 women were analysed. 

At 3 months postpartum, mean Z-scores for the lumbar spine BMD (LS) (-0.49 ± 1.00 [SD]), femoral neck (FN) (-0.29 ± 0.91), and TBS (-0.51 ± 1.08) were below the expected mean of zero. At 12 months postpartum, BMD and TBS Z-scores improved but remained below zero: LS -0.27 ± 1.02, FN -0.26 ± 0.92, and TBS -0.40 ± 0.97.  

At 12 months, despite positive correlation between BMI and absolute BMD, there was inverse relationship between BMI and Z-scores at the LS (r=-0.2, p0.04). Furthermore, we observed a significant negative correlation between total-body fat percentage and Z-scores at LS (r=-0.31, p=0.001) and FN (r=-0.23, p=0.02), and between central fat percentage and Z-scores at LS (r=-0.28, p=0.005) and FN Z-score (r=-0.21, p=0.04). Change in total-body fat% from 3 to 12 months was negatively correlated with change in LS Z-score (r=-0.275, p=0.006) and FN Z-score (r=-0.412, p<0.001). Similar relationships were observed for change in BMI, but not change in central fat%.

At 12 months, women with vitamin D>50 nmol/L had significantly higher LS BMD (1.22 vs 1.15 g/cm2, p=0.004) and LS Z-score (-0.02 vs -0.73, p=0.0006) but there was no FN difference. There was no significant relationship between change in BMD Z-scores and calcium intake, vitamin D, exercise intensity or diabetes status at 12 months. Breastfeeding significantly impacted change in FN absolute BMD.

No consistent associations with TBS Z-scores were observed.

Conclusion: increased adiposity predicts slower recovery of BMD post GDM pregnancy.

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