Maternal plasma visfatin in preterm labor.
OBJECTIVE
Visfatin, a novel adipokine with diabetogenic and immunoregulatory properties, has been implicated in the pathophysiology of insulin resistance, as well as in various acute and chronic inflammatory disorders. We have previously reported that amniotic fluid concentrations of visfatin are higher in patients with preterm labor (PTL) and intra-amniotic infection than in patients with PTL without infection. The aim of this study was to determine whether spontaneous PTL with intact membranes and intra-amniotic infection/inflammation (IAI) is associated with changes in maternal plasma circulating visfatin concentrations.


METHODS
This cross-sectional study included patients in the following groups: (1) normal pregnant women (n = 123); (2) patients with an episode of PTL and intact membranes without IAI who delivered at term (n = 57); (3) PTL without IAI who delivered preterm (n = 47); and (4) PTL with IAI who delivered preterm (n = 57). Plasma visfatin concentrations were determined by ELISA. Non-parametric statistics were used for analysis.


RESULTS
(1) PTL with IAI leading to preterm delivery was associated with a higher median maternal plasma concentration of visfatin than normal pregnancy; (2) among patients with PTL, those with IAI had the highest median maternal concentration of visfatin; (3) the changes in maternal plasma visfatin remained significant after adjusting for maternal age, body mass index, gestational age at sampling, and birth weight.


CONCLUSIONS
(1) PTL with IAI is characterized by high maternal circulating visfatin concentrations; (2) these findings suggest that visfatin plays a role in the regulation of the metabolic adaptations to insults resulting in PTL in the context of IAI.
Mazaki-Tovi
Shali
S
Intramural Division, Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, Maryland, USA.
Romero
Roberto
R
Vaisbuch
Edi
E
Erez
Offer
O
Chaiworapongsa
Tinnakorn
T
Mittal
Pooja
P
Kim
Sun Kwon
SK
Pacora
Percy
P
Gotsch
Francesca
F
Dong
Zhong
Z
Hassan
Sonia S
SS
Kusanovic
Juan Pedro
JP
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000382:microbiology; D001724:Birth Weight; D002821:Chorioamnionitis / Q000201:enzymology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D007752:Obstetric Labor, Premature / Q000201:enzymology*; D011247:Pregnancy
D015850:Interleukin-6; D054409:Nicotinamide Phosphoribosyltransferase