BackgroundLipids and adipokines including leptin, resistin and visfatin play various roles in the pathophysiology of Gestational Diabetes Mellitus (GDM). This study was aimed at determining whether serum leptin, resistin and visfatin are significantly altered during the first trimester of pregnancies that subsequently develop GDM and whether such changes are useful in predicting the disease.MethodsThis was a case-case control study which compared first trimester biochemical and anthropometric parameters in 70 pregnant women who subsequently developed GDM and 70 pregnant women without GDM at the Volta Regional Hospital, Ho, Ghana. Lipid profile and some selected adipokines were analyzed and first trimester body mass index (BMI) was determined.ResultsThere were significant differences (p < 0.05) in leptin, resistin, and visfatin as well as significant dyslipidemia among those with GDM compared to those without GDM. Furthermore, the area under the Receiver Operating Characteristic Curves (AUCs) for leptin, resistin and visfatin were; 0.812, 0.836 and 0.799 respectively. Increased first trimester leptin (OR = 1.166; CI = 1.104–1.233; p < 0.0001), resistin (p < 0.0001) and visfatin (p < 0.0001) were associated with GDM.ConclusionHyperleptinemia, hyperesistinemia and hypervisfatinemia precede GDM and can serve as good predictive indices for gestational diabetes mellitus.