Maternal Serum Visfatin at 11-13 Weeks of Gestation in Gestational Diabetes Mellitus

BACKGROUND: Visfatin and adiponectin are produced by adipose tissue and have opposite effects on insulin resistance. Circulating concentrations of these biomarkers are altered in type 2 diabetes mellitus. We sought to examine the potential value of maternal serum visfatin and adiponectin concentrations in early pregnancy as potential biomarkers in the prediction of gestational diabetes mellitus (GDM). METHODS: This work was a case-control study of 100 women who developed GDM and 300 nondiabetic controls. Maternal serum visfatin and adiponectin were measured between 11 and 13 weeks of gestation. Regression analysis in the nondiabetic group was performed to examine the maternal characteristics affecting the serum concentrations of visfatin and adiponectin. Likelihood ratios for GDM were calculated for visfatin and adiponectin, and performance of screening was assessed by using ROC curve analysis. RESULTS: In the GDM group compared with the nondiabetic group, the median maternal serum visfatin concentration was increased (1.34 multiples of the median [MoM], interquartile range [IQR] 0.70-2.87, vs 1.00 MoM, IQR: 0.53-1.92; P = 0.004) and serum adiponectin was decreased (0.66 MoM, IQR 0.50-0.92, vs 1.01, IQR 0.70-1.29; P < 0.0001). In screening for GDM by a combination of maternal factors and serum adiponectin and visfatin, the estimated detection rate was 68.0% (95% CI 58.3-76.3%), at a false-positive rate of 10%. CONCLUSIONS: At 11-13 weeks in pregnancies that develop GDM, the serum concentration of adiponectin is decreased and visfatin is increased, and these biomarkers can be combined with maternal factors to provide effective early screening for GDM. (C) 2011 American Association for Clinical Chemistry