First trimester adipocytokine concentrations and risk of developing gestational diabetes later in pregnancy

Objective Adipocytokines are important regulators of insulin resistance. The aim of this study was to compare maternal adipocytokines in early pregnancy among women diagnosed with and without gestational diabetes (GDM) months later. Design A nested case-control study. Patients Adiponectin, resistin and interleukin-6 (IL-6) were measured in 59 nulliparous women (30 women with GDM and 29 controls) in plasma obtained in early pregnancy. Patients underwent routine testing for GDM in late pregnancy. Measurements Adiponectin was measured using radioimmunoassay. Resistin and IL-6 were measured by ELISA. Statistical analysis included Student's t-test, logistic regression and Pearson's correlation. Results Groups were not different by baseline descriptors or obstetric outcomes. Mean gestational age at sampling was 9.3 +/- 2.6 weeks. Adiponectin was lower (P < 0.001) in women who later developed GDM compared to controls (4.3 +/- 0.4 vs. 6.9 +/- 0.6 mu g/ml). Adiponectin was negatively associated with the development of GDM (P = 0.002; OR: 0.70, 95% CI: 0.56, 0.88) and the association persisted in multivariable analysis controlling for confounders (P = 0.01; OR: 0.69, 95% CI: 0.52, 0.92). Women with first trimester adiponectin concentrations < 25th% were 10 times more likely to be diagnosed with GDM (OR 10.2; 95% CI 1.3, 78.7). Early adiponectin concentrations negatively correlated with BMI (P = 0.01; r = -0.32) and subsequent 50 g glucose challenge (P = 0.03; r = -0.29). Mean resistin and IL-6 concentrations were not different between the two groups. Conclusions Women with GDM have evidence of altered adipocyte function as measured by adiponectin early in pregnancy, months before the clinical diagnosis of GDM is traditionally made.