Leptin and adiponectin as predictors of cardiovascular risk after gestational diabetes mellitus

Abstract

BackgroundGestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. Adipokine imbalance in the presence of metabolic dysfunction may be a key event in promoting CVD. The aim of the study was to examine the relationships between GDM, cardiovascular risk, and plasma adiponectin, leptin and the leptin/adiponectin (L/A) ratio in pregnancy and at 5 years after the index pregnancy.MethodsThis population-based prospective cohort included 300 women who had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy X-ray absorptiometry, lipid analysis, and pulse wave velocity analysis. Fasting adiponectin and leptin levels were measured four times during pregnancy and at follow-up.ResultsWe found the L/A ratio higher in GDM women both during pregnancy and follow-up compared to non-GDM women. A high L/A ratio during pregnancy was associated with CV risk based on lipid ratios at follow-up, especially the TG/HDL-C ratio. Further, interaction analysis indicated that an increase in the L/A ratio of 1 unit was associated with a higher CV risk in GDM compared to normal pregnancy. Finally, low adiponectin levels independently predicted increased lipid ratios at follow-up.ConclusionsTaken together, our findings suggest that high L/A ratio in pregnancy and in particularly in those with GDM are associated with an unfavorable CVD risk profile during follow-up. Future studies should investigate if a dysregulated leptin and adiponectin profile during pregnancy is associated with atherosclerotic disease during long-term follow-up.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0492-4) contains supplementary material, which is available to authorized users.

Circulating adipokines are associated with pre-eclampsia in women with type 1 diabetes

“…The associations were independent of relevant covariates, including BMI. In other studies of cardiovascular disease, these ratios have predicted events better than the individual measures [41,42]. In the present study, they did not improve upon individual measures until later in pregnancy.…”

“…Measures of leptin have not previously been reported in pregnancies complicated by both type 1 diabetes and preeclampsia. However, previous studies of non-diabetic women, mostly employing a single time point, have demonstrated associations between elevated maternal leptin, as early as 13 weeks' gestation, and the later clinical onset of pre-eclampsia or gestational diabetes mellitus [GDM] [5,25,29,42,43]. Our data are consistent with these, showing that in women with type 1 diabetes who later develop pre-eclampsia, circulating leptin, leptin:total adiponectin ratio and leptin:HMW adiponectin ratio were elevated early in pregnancy and remained so throughout.…”

Adipokines and macrophage markers during pregnancy—Possible role for sCD163 in prediction and progression of gestational diabetes mellitus

“…Absorption was read at 450 nm with wavelength correction set to 540 nm using an ELISA plate reader (Synergy H1 Hybrid, Biotek, Vinooski, Vermont). Leptin and adiponectin analyses have been published before . Intra‐assay and inter‐assay coefficients of variation were less than 10% for all assays.…”

Baseline Leptin/Adiponectin Ratio is a Significant Predictor of BMI Changes in Children/Adolescents after Intensive Lifestyle Intervention

“…The increased leptin/adiponectin ratio has been observed in individuals with diabetes [18] and chronic kidney disease [19] and, significantly, is also associated with increased risk of cardiovascular disease [20,21].…”