Visfatin in human pregnancy: maternal gestational diabetes vis-à-vis neonatal birthweight.
OBJECTIVE
Adipose tissue dysfunction, characterized by dysregulation of adipokines production and/or secretion, has been implicated in the pathophysiology of type-2 diabetes mellitus, a metabolic complication closely related to gestational diabetes mellitus (GDM). Recently, an association between circulating maternal visfatin, a novel adipokine with metabolic and immunoregulatory properties, and impaired glucose metabolism as well as with altered fetal growth, has been proposed. The aims of this study were to determine whether there is an association between maternal plasma visfatin concentration, GDM, and a large-for-gestational-age (LGA) newborn.


METHODS
This cross-sectional study, included pregnant women at term in the following groups: 1) normal pregnancy and an appropriate-for-gestational-age (AGA) neonate (n=54); 2) normal pregnancy and an LGA newborn (n=47); 3) GDM and an AGA newborn (n=56); 4) GDM and an LGA newborn (n=45). The study population was further stratified by first trimester BMI (<25 vs. > or =25 kg/m(2)). Maternal plasma visfatin concentration was determined by ELISA. Parametric and non-parametric statistics were used for analysis.


RESULTS
1) Among women who delivered an AGA neonate, the median maternal plasma concentration of visfatin was higher in patients with GDM than in those with a normal pregnancy; 2) Among women with a normal pregnancy, those who delivered an LGA neonate had a higher median maternal plasma visfatin concentration than those who delivered an AGA neonate; 3) among patients with normal BMI, there were no significant differences in the median maternal plasma visfatin concentration between the four study groups; and 4) maternal GDM, as well as delivery of an LGA neonate were independently associated with a higher maternal plasma visfatin concentrations.


CONCLUSIONS
The linkage between increased maternal circulating visfatin and the presence of GDM or delivery of an LGA neonate supports the hypothesis that perturbation of adipokines homeostasis may play a role in the pathophysiology of GDM or excess fetal growth.
Mazaki-Tovi
Shali
S
Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Bethesda, MD, USA.
Romero
Roberto
R
Kusanovic
Juan Pedro
JP
Vaisbuch
Edi
E
Erez
Offer
O
Than
Nandor Gabor
NG
Chaiworapongsa
Tinnakorn
T
Nhan-Chang
Chia-Ling
CL
Pacora
Percy
P
Gotsch
Francesca
F
Yeo
Lami
L
Kim
Sun Kwon
SK
Edwin
Samuel S
SS
Hassan
Sonia S
SS
Mittal
Pooja
P
D000328:Adult; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005320:Fetal Macrosomia; D006801:Humans; D007231:Infant, Newborn; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D011247:Pregnancy; D055815:Young Adult
D054409:Nicotinamide Phosphoribosyltransferase