High plasma retinol binding protein-4 and low plasma adiponectin concentrations are associated with severity of glucose intolerance in women with previous gestational diabetes mellitus.
BACKGROUND
Women with previous gestational diabetes mellitus (pGDM) are at high risk of developing type 2 diabetes mellitus in the future. The role of adipokines in women with pGDM has not been established.


OBJECTIVE
We investigated whether circulating adipokine concentration is associated with abnormal glucose homeostasis in women with pGDM. DESIGN, SETTING, PATIENTS, AND MAIN OUTCOME MEASURES: We measured the plasma concentrations of retinol-binding protein-4 (RBP4), transthyretin (TTR), and adiponectin and metabolic parameters in four groups of women who exhibited normal glucose tolerance (NGT) during a previous pregnancy (NP, n = 17), NGT after GDM (GDM-NGT, n = 72), impaired glucose tolerance after GDM (GDM-IGT, n = 60), and type 2 diabetes after GDM (GDM-DM, n = 8).


RESULTS
Plasma RBP4 concentration was significantly higher in women with GDM-DM, GDM-IGT, and GDM-NGT than in those with NP. RBP4 concentration correlated positively with TTR concentration; fasting plasma glucose, insulin, and triglyceride concentrations; blood pressure; abdominal fat area; and homeostasis model assessment of insulin resistance. Plasma TTR concentration was elevated in women with GDM-DM compared with other groups. In contrast, adiponectin concentration was lowest in the GDM-DM group and correlated inversely with parameters of insulin resistance. Resistin concentration was higher only in the GDM-NGT and GDM-IGT groups, whereas leptin did not differ between groups. Plasma RBP4 and adiponectin concentrations were inversely correlated.


CONCLUSIONS
The severity of glucose intolerance in women with pGDM is associated with high RBP4 and low adiponectin concentrations.
Choi
Sung Hee
SH
Division of Endocrinology and Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang-Ku, Sungnam City, Gyeonggi-Do 463-707, South Korea.
Kwak
Soo Heon
SH
Youn
Byung-Soo
BS
Lim
Soo
S
Park
Young Joo
YJ
Lee
Hyewon
H
Lee
Namseok
N
Cho
Young Min
YM
Lee
Hong Kyu
HK
Kim
Young-Bum
YB
Park
Kyong Soo
KS
Jang
Hak C
HC
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood*; D006801:Humans; D016014:Linear Models; D024821:Metabolic Syndrome / Q000097:blood; D011228:Prealbumin / Q000032:analysis; D011247:Pregnancy; D054839:Retinol-Binding Proteins, Plasma / Q000032:analysis*
D052242:Adiponectin; D011228:Prealbumin; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma