Inflammatory markers in women with a recent history of gestational diabetes mellitus

Benedetto, A. Di; Russo, Giuseppina T.; Corrado, Francesco; Cesare, E. Di; Alessi, Eugenio; Nicocia, Giacomo; D’Anna, Rosario; Cucinotta, Domenico

doi:10.1007/bf03345527

Cited by 82 publications

(50 citation statements)

References 29 publications

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“…This contrasts with previous reports where CRP levels have been found to be elevated in diabetic and insulin-resistant individuals (9,10,39,41). However, in the Diabetes Heart Study, there was no difference in CRP levels between type 2 diabetic subjects and their unaffected siblings (42), although a significant relationship was found between BMI and CRP in the same study as in the data reported here.…”

Section: The Contribution Of Adipose Tissue To Adipokine Levelscontrasting

confidence: 99%

Ethnicity, Insulin Resistance, and Inflammatory Adipokines in Women at High and Low Risk for Vascular Disease

et al. 2007

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OBJECTIVE -We sought to compare the relationship between body composition, insulin resistance, and inflammatory adipokines in Aboriginal Canadian women, who are at high risk of vascular disease, with white women. RESEARCH DESIGN AND METHODS -A subgroup of the First Nations Bone HealthStudy population, consisting of 131 Aboriginal women and 132 matched white women, was utilized. Body composition was determined by whole-body dual X-ray absorptiometry, and blood analytes were measured after an overnight fast.RESULTS -After excluding individuals with diabetes, A1C, BMI, percent trunk fat, and homeostasis model assessment of insulin resistance (HOMA-IR) were greater in First Nation women compared with white women, whereas adiponectin, retinol binding protein (RBP)4, and insulin-like growth factor binding protein-1 (IGFBP-1) were lower. First Nation women had more trunk fat for any given level of total fat than white women. There were no differences in resistin, leptin, tumor necrosis factor (TNF)-␣, or C-reactive protein (CRP) levels between First Nation and white women. Insulin resistance correlated with leptin and inversely with adiponectin levels in both First Nation and white women. There were weak correlations between insulin resistance and TNF-␣, interleukin-6, and CRP, but these were not significant after correction for body fat. No correlation was found between RBP4 and insulin resistance. ANCOVA revealed a higher HOMA-IR adjusted for total body fat in First Nation women than in white women (P ϭ 0.015) but not HOMA-IR adjusted for trunk fat (P Ͼ 0.2).CONCLUSIONS -First Nation women are more insulin resistant than white women, and this is explained by trunk fat but not total fat. Despite the increased insulin resistance, inflammatory adipokines are not significantly increased in First Nation women compared with white women. Diabetes Care 30:286 -291, 2007A n increased prevalence of vascular disease in insulin-resistant states such as pre-diabetes, type 2 diabetes, and the metabolic syndrome has been long recognized (1). There is considerable debate whether insulin resistance is the primary event in atherosclerosis, with consequent activation of proinflammatory signaling pathways, or, alternatively, whether low-grade inflammation and subsequent insulin resistance accounts for the association of diabetes and vascular disease (2).Aboriginal Canadian populations, which include First Nation, Metis, and Inuit individuals (3), have an increased prevalence of atherosclerosis and cardiovascular and peripheral vascular disease (4,5). First Nations are Aboriginal individuals signatory to treaties and/or recognized by the Canadian Federal Government as a fiduciary responsibility and represent the large majority of Aboriginal individuals living in Canada (3). While type 2 diabetes is more prevalent among Canadian men than women in the general population, the reverse is true for the First Nation population (6,7). In the First Nation population, obesity is more prevalent among men than women, but the prevalence of metabolic ...

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Section: The Contribution Of Adipose Tissue To Adipokine Levelscontrasting

confidence: 99%

Ethnicity, Insulin Resistance, and Inflammatory Adipokines in Women at High and Low Risk for Vascular Disease

et al. 2007

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“…In fact, both subclinical inflammation and hypoadiponectinaemia may be chronic defects in this patient population, as increased CRP and low adiponectin in the first trimester have each been shown to independently predict the subsequent development of GDM later during pregnancy [22,23]. Moreover, a limited number of studies following pregnancy have also reported increased levels of inflammatory markers and decreased adiponectin in women with a history of GDM [24][25][26]. By documenting their existence both during pregnancy and at 3 months postpartum, the current study supports the potential chronic nature of these defects, and thereby suggests that they may be of pathophysiological relevance to diabetic risk in this patient population.…”

Section: Discussionmentioning

confidence: 95%

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia

Retnakaran

Qi²,

Connelly

et al. 2009

Diabetologia

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Aims/hypothesis The postpartum phase following gestational diabetes (GDM) is characterised by subtle metabolic defects, including the beta cell dysfunction that is believed to mediate the increased future risk of type 2 diabetes in this patient population. Low circulating levels of adiponectin and increased leptin and C-reactive protein (CRP) have recently emerged as novel diabetic risk factors, although their relevance to GDM and subsequent diabetes has not been characterised. Thus, we sought to determine whether adiponectin, leptin and CRP levels during pregnancy relate to the postpartum metabolic defects linking GDM with type 2 diabetes.Methods Metabolic characterisation, including oral glucose tolerance testing, was undertaken in 487 women during pregnancy and at 3 months postpartum. Based on the antepartum OGTT, there were 137 women with GDM, 91 with gestational impaired glucose tolerance and 259 with normal glucose tolerance. Results Adiponectin levels were lowest (p<0.0001) and CRP levels highest (p=0.0008) in women with GDM. Leptin did not differ between the glucose tolerance groups (p = 0.4483). Adiponectin (r = 0.41, p < 0.0001), leptin (r= −0.36, p <0.0001) and CRP (r = −0.30, p < 0.0001) during pregnancy were all associated with postpartum insulin sensitivity (determined using the insulin sensitivity index of Matsuda and DeFronzo [IS OGTT ]). Intriguingly, adiponectin levels were also related to postpartum beta cell function (insulinogenic index/HOMA of insulin resistance; r=0.16, p=0.0009). Indeed, on multiple linear regression analyses, adiponectin levels during pregnancy independently predicted both postpartum insulin sensitivity (t=3.97, p<0.0001) and beta cell function (t=2.37, p=0.0181), even after adjustment for GDM. Furthermore, adiponectin emerged as a significant negative independent determinant of postpartum fasting glucose (t=−3.01, p=0.0027). Conclusions/interpretation Hypoadiponectinaemia during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia, and hence may be relevant to the pathophysiology relating GDM with type 2 diabetes.

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“…Average hsCRP and interleukin-6, but not tumor necrosis factor-␣, were higher in a prior GDM group than in control subjects 3 months after delivery in Austria, with or without direct measures of insulin resistance (149). In Italy, hsCRP and fibrinogen concentrations were significantly elevated in women 1-3 years after pregnancy with GDM, even excluding women with IGT (142). Gestational hyperglycemia predicted a high risk of later metabolic syndrome after adjustments for age and prepregnancy BMI in another Italian study (150).…”

Section: Cardiovascular Risks In Women With Priormentioning

confidence: 88%

“…On the other hand, standard lipoprotein concentrations were not different in women with prior GDM compared with control subjects 1-3 years after pregnancy in Italy (142) and in Spain, despite the increased BMI and waist circumference (30). In the latter study, women with IFG had significantly increased odds ratios for obesity and hypertension than the women with postpartum IGT (30).…”

Section: Cardiovascular Risks In Women With Priormentioning

confidence: 99%

Gestational Diabetes After Delivery

Dang-Kilduff²,

2007

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Inflammatory markers in women with a recent history of gestational diabetes mellitus

Cited by 82 publications

References 29 publications

Ethnicity, Insulin Resistance, and Inflammatory Adipokines in Women at High and Low Risk for Vascular Disease

Ethnicity, Insulin Resistance, and Inflammatory Adipokines in Women at High and Low Risk for Vascular Disease

Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia

Gestational Diabetes After Delivery

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