Adipokine profile and C-reactive protein in pregnancy: effects of glucose challenge response versus body mass index.
OBJECTIVE
To test the hypothesis that gravidas who have an abnormal response to glucose loading have dysfunctional adipose tissue cells that produce more insulin resistance-inducing and proinflammatory adipokines but less insulin-sensitizing adipokines.


METHODS
We performed a nested case-control study within a larger sample of gravidas who had a glucose challenge test (GCT) at 24-29 weeks; we compared 73 cases with an abnormal GCT (>8.3 mM) and 146 controls with a strictly normal GCT (<7.2 mM) matched for body mass index (BMI) and height (mean difference between cases and controls: 0.1 kg/m(2) and 1 cm, respectively). We measured plasma insulin, adipokines (leptin, adiponectin, resistin, tumor necrosis factor [TNF]-alpha, interleukin [IL]-6), soluble leptin receptor (sOb-R), the main leptin-binding protein, and C-reactive protein (CRP).


RESULTS
The cases showed a 48% increase in insulin concentrations and a 27% increase in TNF-alpha concentrations compared to the controls (both P < .0001), but leptin, sOb-R, IL-6, and adiponectin, as well as CRP, concentrations were comparable between cases and controls. In the whole group (n = 219), BMI was correlated with insulin, leptin, IL-6, and CRP, and inversely with sOb-R and adiponectin concentrations (all P < .0003).


CONCLUSIONS
Plasma leptin, sOb-R, IL-6, and adiponectin, as well as CRP, are strongly related to BMI in gravidas at 24-29 weeks gestational age but not to the glucose loading response. However, TNF-alpha is higher in women with an abnormal GCT. Further studies should disclose the source of increased TNF-alpha in these women, and to assess whether TNF-alpha is causally related to glucose intolerance during pregnancy.
Department of Obstetrics and Gynecology, Katholieke Universiteit Leuven, Leuven, Belgium. johan.verhaeghe@uz.kuleuven.ac.be <johan.verhaeghe@uz.kuleuven.ac.be>
Johan
J
Verhaeghe
Rita
R
van Bree
Suzan
S
Lambin
Silvia
S
Caluwaerts
D017667:Adipocytes / Q000502:physiology*; D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein; D016022:Case-Control Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D036361:Peptide Hormones / Q000097:blood; D011247:Pregnancy / Q000502:physiology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011956:Receptors, Cell Surface / Q000097:blood; D054411:Receptors, Leptin
D007328:Insulin; D036361:Peptide Hormones; D011956:Receptors, Cell Surface; D054411:Receptors, Leptin; D002097:C-Reactive Protein