Second trimester maternal plasma and amniotic fluid adipokines in women who will develop gestational diabetes mellitus

Abstract

Objective: To study the adipokines concentration and glucose homoeostasis in the early-second trimester of women who will develop gestational diabetes mellitus (GDM).

Materials and methods: Maternal plasma and fetal amniotic fluid samples were prospectively collected between 2006 and 2007 at the time of mid-trimester amniocentesis. Eight patients found to be affected by GDM were compared with 10 control patients with a normal pregnancy course. Adipokines leptin and adiponectin, as well as insulin and glucose concentration both in amniotic fluid and maternal plasma were compared between cases and controls. HOMA-IR (homeostatic model assessment for insulin resistance) was also calculated both for amniotic fluid and maternal serum.

Results: The amniotic fluid adiponectin concentration was higher in women who would develop GDM than in controls (29.9 ng/ml, 95% CI 26.7–49.8 ng/ml, versus 14.9 ng/ml, 95% CI 13.5–18.8 ng/ml), p < 0.05). No difference was shown for leptin both in amniotic fluid and maternal serum. Insulin concentrations in the amniotic fluid were found to be lower in GDM than in controls, while HOMA-IR-index resulted lower in amniotic fluid and higher maternal serum (p < 0.05).

Conclusions: Our data suggests that an earlier alteration in the fetal glucose metabolism will precede the glucose dysmetabolism in pregnancies later complicated by GDM.

Chinese abstract

目的：探讨妊娠期糖尿病妇女（GDM）孕中期早期脂肪因子浓度和血糖稳态的变化。

材料和方法：预先收集2006至2007年间孕中期行羊膜穿刺术收集的孕妇血浆和胎儿羊水样本。GDM患者8例和正常妊娠患者10例。在实验组和对照组中分别比较羊水和母体血浆中脂肪因子瘦素、脂联素及胰岛素和血糖浓度。同时也计算HOMA-IR（胰岛素抵抗稳态模型评估）。

结果：与对照组相比，GDM妇女羊水脂联素浓度明显增高（29.9 ng/ml, 95% CI 26.7–49.8 ng/ml, 比 14.9 ng/ml, 95% CI 13.5–18.8 ng/ml, p < 0.05）。羊水和母体血清中瘦素浓度无明显差异。与对照组相比，GDM妇女羊水中胰岛素浓度较低；羊水中HOMA-IR指数较低，而母体血清中HOMA-IR指数较高（p < 0.05）。

结论：我们的研究数据表明妊娠期糖尿病患者胎儿糖代谢早期改变先于妊娠后期引起的葡萄糖代谢障碍的发生。

Keywords:

• Adipokines
• adiponectin
• amniotic fluid
• gestational diabetes mellitus
• insulin resistance
• leptin
• plasma
• pregnancy

Acknowledgements

The study results were presented at the 58th Congress of the German Society of Gynecology and Obstetrics (Munich 2010) and at the 15th World Congress on Human Reproduction (Venice, 2013).

Declaration of interest

The authors report no conflicts of interest.