Maternal Plasma Adiponectin Concentrations at 24 – 31 Weeks’ Gestation: Negative Association with Gestational Diabetes Mellitus.

Abstract

Objective Adiponectin is an adipocyte-derived hormone with antidiabetic, antiatherosclerotic, and antiinflammatory properties. This study investigated the relations between maternal adiponectin concentration and gestational diabetes mellitus (GDM) and other metabolic parameters during midpregnancy.

Methods Two-hour 75-g oral glucose tolerance tests were performed in 253 pregnant women at 24 to 31 wk of gestation. Two hundred nineteen who had normal glucose tolerance (NGT) and 34 women who had GDM and their newborns were investigated. Fasting maternal blood samples were drawn to determine plasma concentrations of adiponectin, glucose, insulin, C-peptide, free fatty acid, and blood lipids. Blood samples at 1 and 2 h after an oral glucose load were obtained to measure plasma glucose, insulin, and C-peptide concentrations.

Results Plasma adiponectin concentrations were significantly lower in women who had GDM than in those who had NGT (P = 0.014). Maternal age, body mass index (before pregnancy and at blood collection), and plasma level of free fatty acid were significantly greater in those who had GDM than in those who had NGT. Logistic regression analysis showed that maternal adiponectin level and GDM were significantly correlated (P = 0.043), but that the correlation became weaker (P = 0.116) after adjusting for maternal body mass index and plasma level of free fatty acid before pregnancy. In the NGT group, maternal adiponectin concentrations were significantly negatively correlated with plasma fasting insulin, fasting C-peptide, fasting C-peptide/fasting glucose ratio, 2-h glucose, triacylglycerol, and maternal body mass index and positively correlated with high-density lipoprotein cholesterol concentration. In the GDM group, maternal adiponectin level was negatively correlated with neonatal birth weight.

Conclusions Midpregnancy hypoadiponectinemia may be associated with a higher risk of GDM.