Adipokine levels and their association with insulin resistance and fetal outcomes among the newborns of Indian gestational diabetic mothers

Abstract

Objectives: To investigate the cord blood levels of adipokine and to assess their association with the fetal insulin resistance and fetal outcomes in newborns of gestational diabetic women (GDM). Methods: This cross-sectional study was performed in 40 GDM women and 40 healthy pregnant women (HPW) in the Department of Obstetrics and Gynecology at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) hospital in Puducherry, India, during the period from May 2016 to December 2017. Cord blood samples were collected at delivery from GDM and HPW groups. Cord plasma biochemical parameters such as insulin, C-peptide, adiponectin, leptin, resistin, and visfatin concentrations were measured. Leptin/adiponectin ratio (L/A), homeostasis model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-%S) and beta cell function (HOMA2-%B) were calculated. The pregnancy outcomes such as birth weight (BW), Ponderal index and Apgar scores of the baby were measured. Results: The BW and Ponderal index of the baby were found to be significantly higher in GDM newborns compared to HPW newborns. Cord plasma insulin, C-peptide, HOMA2 –IR, visfatin, leptin, and L/A ratio were significantly higher whereas adiponectin level was lower in GDM compared to HPW. A significant positive correlation was observed between L/A ratio and fetal HOMA2-IR. Conclusion: Altered adipokine levels with increased L/A ratio was observed among the new-borns of Indian gestational diabetic mothers. There was an association between increased L/A ratio, insulin resistance and increased Ponderal index among the new-borns.

Placental Accumulation of Triacylglycerols in Gestational Diabetes Mellitus and Its Association with Altered Fetal Growth are Related to the Differential Expressions of Proteins of Lipid Metabolism

“…This would have brought down fetal TG level and elevated FFAs. We previously reported that there was hyperinsulinemia in cord blood samples of GDM [60]. This would have promoted the storage of FFAs in fetal adipose tissue culminating in fetal fat accumulation and adiposity.…”

Blood level of adipokines and nutritional status variables in adolescent pregnancy

“…This result was also observed in adult women during healthy pregnancies [ 15 , 16 ]. A possible explanation would be due to the installation and/or change of IR, which tends to increase with the evolution of pregnancy and returns to pre-pregnancy values after delivery [ 17 , 18 ]. Thus, we found a negative correlation between gestational age and serum adiponectin concentration, which is also described in the literatures including other age groups [ 19 , 20 ].…”

Effect of Gestational Diabetes on Serum Leptin during Pregnancy and Postpartum Period

“…IL-6 &TNF-α leading to inflammation and further increase in serum leptin. These cytokines increase the insulin resistance, resulting in hyperinsulinemia which results in hyperleptinemia (9). This study was planned to find correlation between GDM and serum leptin levels among Pakistani women as limited research data is available.…”