RESEARCH PAPER
Correlation between atherogenic risk and adiponectin in gestational diabetes mellitus
 
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1
Chair and Department of Endocrinology, Medical University of Lublin, Poland
2
Department of Laboratory Diagnostics, Medical University of Lublin, Poland
3
Institute of Rural Health in Lublin, Poland
4
Department of Gynecology and Obstetric, City Hospital in Świdnik, Poland
5
3rd Chair and Department of Gynecology, Medical University of Lublin, Poland
CORRESPONDING AUTHOR
Jolanta Kowalczyk-Bołtuć   

Institute of Rural Health in Lublin, Poland
 
Ann Agric Environ Med. 2014;21(1):143–147
 
KEYWORDS
ABSTRACT
Introduction and objective:
Gestational diabetes mellitus (GDM) is a pregnancy complication which increases the risk for maternal and foetal complications during pregnancy, and also significantly increases the cardiovascular risk for women’s health in the postpartum. Current literature provides contradictory information on the role of adiponectin (AdipoQ) in the course of GDM. The aim of the study was to measure AdipoQ concentration in blood of women with GDM and to find correlations between this adipokine and clinical and biochemical parameters of the atherogenic risk.

Material and Methods:
The GDM group included 50 women diagnosed with GDM between 24 – 28 weeks of gestation who underwent routine prenatal tests for GDM in compliance with the guidelines of the Polish Diabetes Association. All patients underwent clinical and laboratory evaluation at GDM diagnosis. Laboratory tests included serum AdipoQ concentration, fasting glucose and insulin, OGTT, lipid parameters, C-reactive protein and fibrinogen in serum.

Results:
The GDM group showed significantly elevated fasting glucose, insulin, HOMA-IR values, total cholesterol, LDLcholesterol and triglicerydes as compared with the control group (p<0.05). The atherogenic index, CRP, fibrinogen in women with GDM were significantly higher than in the control group (p<0.05). AdipoQ concentrations did not differ significantly between the groups during gestation (p=0.7054). No correlations, except with the neonatal weight (r= – 0.29, p<0.05), were found between AdipoQ and the studied parameters.

Conclusions:
Based on the conducted studies, it may be conclude that women with early diagnosed and promptly treated GDM have a normal adiponectin level, although insulin resistant changes and increased cardiovascular risk in basic metabolic parameters are observed. Moreover, adiponectin does not reflect the atherogenic risk in pregnant women with GDM.

 
REFERENCES (39)
1.
Polskie Towarzystwo Diabetologiczne: Zalecenia kliniczne dotyczące postępowania u chorych na cukrzycę. Diabetol. Prakt. 2011; 12: 39–41 (in Polish).
 
2.
Hunt KJ, Logan SL, Conway DL, Korte JE. Postpartum screening following GDM: how well are we doing? Curr Diab Rep. 2010;10(3): 235–241.
 
3.
Zatońska K, Ilow R, Regulska-Ilow B, Różańska D, Szuba A, Wołyniec M et al. Prevalence of diabetes mellitus and IFG in the prospective cohort ‘PONS’ study – baseline assessment. Ann Agric Environ Med. 2011;18(2): 265–269.
 
4.
Nwose EU, Richards RS, Bwititi PT, Butkowski EG. New guidelines for diagnosis of gestational diabetes: pathology-based impact assessment. N Am J Med Sci. 2013; 5(3):191–194.
 
5.
Verma A, Boney CM, Tucker R, Vohr BR. Insulin resistance syndrome in women with prior history of gestational diabetes mellitus. J Clin Endocrinol Metab. 2002; 87(7): 3227–3235.
 
6.
Sullivan SD, Umans JG, Ratner R. Gestational diabetes: implications for cardiovascular health. Curr Diab Rep. 2012;12(1): 43–52.
 
7.
Heitritter SM, Solomon CG, Mitchell GF, Skali-Ounis N, Seely EW. Subclinical inflammation and vascular dysfunction in women with previous gestational diabetes mellitus. J Clin Endocrinol Metab. 2005; 90(7): 3983–3988.
 
8.
Fain JN, Madan AK, Hiler ML, Cheema P, Bahouth SW. Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology. 2004;145(5): 2273–2282.
 
9.
Gil-Campos M, Cañete RR, Gil A. Adiponectin, the missing link in insulin resistance and obesity. Clin Nutr. 2004;23(5): 963–974.
 
10.
Karpe F. Insulin resistance by adiponectin deficiency: is the action in skeletal muscle? Diabetes. 2013; 62(3): 701–702.
 
11.
Villarreal-Molina MT, Antuna-Puente B. Adiponectin: antiinflammatory and cardioprotective effects. Biochimie. 2012; 94(10): 2143–2149.
 
12.
Siasos G, Tousoulis D, Kollia C, Oikonomou E, Siasou Z, Stefanadis C et al. Adiponectin and cardiovascular disease: mechanisms and new therapeutic approaches.CDobiasova M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001; 34(7): 583–588.
 
13.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–419.
 
14.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25): 3143–3421.
 
15.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–420.
 
16.
Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y et al. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol. 2000; 20(6):1595–1599.
 
17.
Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001; 86(5): 1930–1935.
 
18.
Catalano PM, Hoegh M, Minium J, Huston-Presley L, Bernard S, Kalhan S et al. Adiponectin in human pregnancy: implications for regulation of glucose and lipid metabolism. Diabetologia. 2006; 49(7): 1677–1685.
 
19.
Sullivan SD, Umans JG, Ratner R. Gestational diabetes: implications for cardiovascular health. Curr Diab Rep. 2012; 12(1): 43–52.
 
20.
McLachlan KA, O’Neal D, Jenkins A, Alford FP. Do adiponectin, TNFalpha, leptin and CRP relate to insulin resistance in pregnancy? Studies in women with and without gestational diabetes, during and after pregnancy. Diabetes Metab Res Rev. 2006; 22(2): 131–138.
 
21.
Saucedo R, Zarate A, Basurto L, Hernandez M, Puello E, Galvan R, Campos S. Relationship between circulating adipokines and insulin resistance during pregnancy and postpartum in women with gestational diabetes. Arch Med Res. 2011; 42(4): 318–323.
 
22.
Retnakaran R, Hanley AJ, Raif N, Connelly PW, Sermer M, Zinman B. Reduced adiponectin concentration in women with gestational diabetes: a potential factor in progression to type 2 diabetes.Diabetes Care. 2004; 27(3): 799–800.
 
23.
Thyfault JP, Hedberg EM, Anchan RM, Thorne OP, Isler CM, Newton ER et al. Gestational diabetes is associated with depressed adiponectin levels. J Soc Gynecol Investig. 2005; 12(1): 41–45.
 
24.
Mazaki-Tovi S, Romero R, Kusanovic JP, Erez O, Vaisbuch E, Gotsch F et al. Adiponectin multimers in maternal plasma. J Matern Fetal Neonatal Med. 2008; 21(11): 796–815.
 
25.
Lowe LP, Metzger BE, Lowe WL Jr, Dyer AR, McDade TW, McIntyre HD et al. Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. J Clin Endocrinol Metab. 2010; 95(12): 5427–5434.
 
26.
Retnakaran R, Hanley AJ, Connelly PW, Sermer M, Zinman B. Ethnicity modifies the effect of obesity on insulin resistance in pregnancy: a comparison of Asian, South Asian, and Caucasian women. J Clin Endocrinol Metab. 2006; 91(1): 93–97.
 
27.
Wulan SN, Westerterp KR, Plasqui G.Ethnic differences in body composition and the associated metabolic profile: a comparative study between Asians and Caucasians. Maturitas. 2010; 65(4): 315–319.
 
28.
Leary J, Pettitt DJ, Jovanovic L. Gestational diabetes guidelines in a HAPO world. Best Pract Res Clin Endocrinol Metab. 2010; 24(4): 673–685.
 
29.
Mazaki-Tovi S, Romero R, Vaisbuch E, Erez O, Mittal P, Chaiworapongsa T et al. Maternal serum adiponectin multimers in gestational diabetes. J Perinat Med. 2009; 37(6): 637–650.
 
30.
Basaran A. Pregnancy-induced hyperlipoproteinemia: review of the literature. Reprod Sci. 2009; 16(5): 431–437.
 
31.
Kopp HP, Krzyzanowska K, Möhlig M, Spranger J, Pfeiffer AF, Schernthaner G. Effects of marked weight loss on plasma levels of adiponectin, markers of chronic subclinical inflammation and insulin resistance in morbidly obese women. Int J Obes (Lond). 2005; 29(7): 766–71.
 
32.
Owecki M, Miczke A, Pupek-Musialik D, Bryl W, Cymerys M, Nikisch E et al. Circulating serum adiponectin concentrations do not differ between obese and non-obese caucasians and are unrelated to insulin sensitivity. Horm Metab Res. 2007; 39(1): 25–30.
 
33.
Carr DB, Utzschneider KM, Hull RL, Tong J, Wallace TM, Kodama K, Shofer JB, Heckbert SR, Boyko EJ, Fujimoto WY, Kahn SE. Gestational diabetes mellitus increases the risk of cardiovascular disease in women with a family history of type 2 diabetes. Diabetes Care. 2006; 29(9): 2078–2083.
 
34.
Ko GT, Yeung VT, Chan JC, Chow CC, Li JK, So WY at al. Plasma fibrinogen concentration in a Chinese population. Atherosclerosis. 1997; 131(2): 211–217.
 
35.
Ferraz TB, Motta RS, Ferraz CL, Capibaribe DM, Forti AC, Chacra AR. C-reactive protein and features of metabolic syndrome in Brazilian women with previous gestational diabetes. Diabetes Res Clin Pract. 2007; 78(1): 23–29.
 
36.
Rivero K, Portal VL, Vieira M, Behle I. Prevalence of the impaired glucose metabolism and its association with risk factors for coronary artery disease in women with gestational diabetes. Diabetes Res Clin Pract. 2008; 79(3): 433–437.
 
37.
Tsai PJ, Yu CH, Hsu SP, Lee YH, Huang IT, Ho SC et al. Maternal plasma adiponectin concentrations at 24 to 31 weeks of gestation: negative association with gestational diabetes mellitus. Nutrition. 2005; 21(11–12): 1095–1099.
 
38.
Kajantie E, Hytinantti T, Hovi P, Andersson S. Cord plasma adiponectin: a 20-fold rise between 24 weeks gestation and term. J Clin Endocrinol Metab. 2004; 89(8): 4031–4036.
 
39.
Nanda S, Akolekar R, Sarquis R, Mosconi AP, Nicolaides KH. Maternal serum adiponectin at 11 to 13 weeks of gestation in the prediction of macrosomia. Prenat Diagn. 2011; 31(5): 479–483.
 
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