Maternal serum adiponectin multimers in gestational diabetes.
OBJECTIVE
Adiponectin, an adipokine with profound insulin-sensitizing effect, consists of heterogeneous species of multimers. These oligomeric complexes circulate as low-molecular-weight (LMW) trimers, medium-molecular-weight (MMW) hexamers and high-molecular-weight (HMW) isoforms and can exert differential biological effects. The aims of this study were to determine whether there is a change in circulating adiponectin multimers in the presence of gestational diabetes mellitus (GDM), overweight/obesity or with a treatment with sulfonylurea or insulin in patients with GDM.


METHODS
This cross-sectional study included women with: 1) normal pregnancy (n=149); and 2) patients with GDM (n=72). Thirty-three patients with GDM were managed with diet alone. Among the others 39 diabetic patients, 17 were treated with Glyburide and 22 with insulin. The study population was further stratified by first trimester body mass index (BMI) (normal weight <25 kg/m(2) vs. overweight/obese > or =25 kg/m(2)). Serum adiponectin multimers (total, HMW, MMW and LMW) concentrations were determined by ELISA.


RESULTS
1) The median maternal serum of total, HMW, MMW and LMW were lower in patients with GDM than in those with normal pregnancies (P<0.001 for all comparisons); 2) patients with GDM had a lower HMW/total adiponectin ratio and a higher MMW/total and LMW/total adiponectin ratio than those with a normal pregnancy (P<0.001 for all comparisons); and 3) among GDM patients, there were no differences in the concentrations and relative distribution of adiponectin multimers between those who were managed with diet, and those who were treated with pharmacological agents.


CONCLUSIONS
1) GDM is characterized by a distinctive pattern of concentrations and relative distribution of adiponectin multimers akin to Type 2 diabetes mellitus; 2) dysregulation of adiponectin multimeres can provide a mechanistic basis for the association between adiposity and GDM.
Mazaki-Tovi
Shali
S
Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Detroit, MI 48201, USA.
Romero
Roberto
R
Vaisbuch
Edi
E
Erez
Offer
O
Mittal
Pooja
P
Chaiworapongsa
Tinnakorn
T
Kim
Sun Kwon
SK
Pacora
Percy
P
Yeo
Lami
L
Gotsch
Francesca
F
Dong
Zhong
Z
Yoon
Bo Hyun
BH
Hassan
Sonia S
SS
Kusanovic
Juan Pedro
JP
D052242:Adiponectin / Q000097:blood / Q000737:chemistry; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005905:Glyburide / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008970:Molecular Weight; D009765:Obesity / Q000097:blood / Q000150:complications / Q000473:pathology; D050177:Overweight / Q000097:blood / Q000150:complications / Q000473:pathology; D011247:Pregnancy; D020836:Protein Structure, Quaternary; D055815:Young Adult
C499918:ADIPOQ protein, human; D052242:Adiponectin; D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide