Maternal circulating levels of Adipocytokines and insulin resistance as predictors of gestational diabetes mellitus: preliminary findings of a longitudinal descriptive study

Abstract

Purpose The present study aimed to assess the role of adipocytokines as predictive markers of gestational diabetes mellitus (GDM). We undertook this study to explore the association of adiponectin, resistin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) and insulin resistance in the development of GDM. Methods This longitudinal descriptive study was done in the Medical College Hospital, involving the departments of Biochemistry and Gynecology. The study subjects were pregnant women with normal body mass index. They were recruited at 12-14 weeks of gestation, The healthy pregnant women were selected and were followed at 24-28 weeks for screening of GDM. The participants were categorized as healthy and GDM based on oral glucose tolerance test results. Blood samples were collected on both the occasions at 12-14 weeks and 24-28 weeks. The serum samples were analyzed for levels of insulin, adiponectin, resistin, IL-6 and TNF-alpha. Insulin resistance (HOMA-IR) was calculated from serum insulin and plasma glucose values. ResultsThe levels of HOMA-IR, resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was significantly lower in GDM subjects in comparison to healthy pregnant women, when compared both at 12 weeks and 24 weeks. The levels of resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was lower at 24 weeks in comparison to 12 weeks, in the healthy pregnant women as well as those with GDM . Conclusions Significant difference in the levels of adipocytokines between the healthy and GDM pregnant women suggest potential clinical application of these molecules as biomarkers of GDM. The increase or decrease in the levels of adipocytokines during the course of pregnancy in GDM subjects suggests their role in GDM and potential use as predictive markers.

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

“…Adiponectin circulating levels increase during the first and second trimesters of normal pregnancy and later decrease post-partum [ 178 ]. Unlike leptin, low levels of adiponectin were found in maternal GDM serum compared to women with normal glucose tolerance [ 179 , 180 ]. It has been proposed that this decrease in serum adiponectin levels may serve as an early predictive factor for GDM development.…”

High Serum Levels of Afamin and Tumor Necrosis Factor-α during The First Trimester might be used as Early Predictors for Gestational Diabetes Mellitus in Euglycemic Pregnant women

“…Thereafter, Jin et al [30] reported that the dynamic change in fetuin-A levels was associated with the changes in IR and β-cell function from the 1st to the 2nd trimester, and was associated with an increased risk of the development of GDM. Also, Ramachandrayya et al [31] found the levels of resistin, IL-6 and TNF-α were higher at 24 than at 12 GW in both healthy pregnant and GDM women with significantly higher levels in women with GDM than women with healthy pregnancy. Recently, Eroğlu et al [32] detected higher serum levels of afamin in women who developed GDM than control women and Al-Musharaf et al [33] detected significantly and progressively increasing serum levels of TNF-α, leptin and resistin from the 1st to the 2nd trimester in GDM women than in no-GDM women and considered these disturbed levels of adipocytokines during the course of pregnancy may play a role in pathogenesis of GDM.…”

The role of lipid dysregulation in gestational diabetes mellitus: Early prediction and postpartum prognosis

“…The adipose tissue secretes multiple adipokines which are mostly pro‐inflammatory 59 and are associated with various metabolic diseases, such as GDM, type 2 diabetes, and obesity 60 . Adiponectins have been shown to be negatively associated with GDM 60 , whereas leptin was linked with a higher risk of GDM 61 .…”