Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study.
BACKGROUND
Inflammatory mediators are associated with type 2 and gestational diabetes. It is unknown whether there are associations with glucose in pregnant women with lesser degrees of hyperglycemia.


OBJECTIVE
The objective of the study was to examine associations of inflammatory mediators with maternal glucose levels and neonatal size in a subset of participants in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study.


METHODS
Eligible pregnant women underwent a 75-g oral glucose tolerance test between 24 and 32 wk gestation, and levels of C-peptide, adiponectin, plasminogen activator inhibitor type 1 (PAI-1), C-reactive protein (CRP), and resistin were measured in fasting serum samples. Associations of inflammatory mediators with maternal glucose and with birth size were assessed using multiple linear regression analyses, adjusting for maternal body mass index (BMI), fasting C-peptide, and other potential confounders.


RESULTS
Mean levels of adiponectin declined, and PAI-1 and CRP increased across increasing levels of maternal glucose, BMI, and C-peptide. For example, for fasting plasma glucose less than 75 mg/dl and fasting plasma glucose of 90 mg/dl or greater, adiponectin was 22.5 and 17.4 μg/ml and PAI-1 was 30.9 and 34.2 ng/ml, respectively. Associations with 1- and 2-h plasma glucose remained significant for adiponectin (P<0.001), PAI-1 (P<0.05), and CRP (P<0.01) after adjustment for BMI and C-peptide. Adiponectin and CRP were inversely associated with birth weight, sum of skinfolds and percent body fat, and PAI-1 with sum of skinfolds (all P<0.05) after adjustment for confounders. Resistin was not associated with 1- or 2-h glucose or birth size.


CONCLUSIONS
Levels of inflammatory mediators are associated with levels of maternal glucose in pregnant women without overt diabetes.
Lowe
Lynn P
LP
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, Illinois 60611, USA. lplowe@northwestern.edu
Metzger
Boyd E
BE
Lowe
William L
WL
Dyer
Alan R
AR
McDade
Thomas W
TW
McIntyre
H David
HD
D052242:Adiponectin / Q000097:blood; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D049628:Body Size; D002096:C-Peptide / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000503:physiopathology*; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D011256:Pregnancy Outcome; D052243:Resistin / Q000097:blood
D052242:Adiponectin; D001786:Blood Glucose; D002096:C-Peptide; D017395:Plasminogen Activator Inhibitor 1; D052243:Resistin; D002097:C-Reactive Protein