title: Relationship between circulating adipokines and insulin resistance during pregnancy and postpartum in women with gestational diabetes.
abstract: OBJECTIVE
  We undertook this study to assess the relationship between circulating adipokines and insulin resistance during pregnancy and postpartum in women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  This was a prospective study including 60 women with GDM and 60 subjects with normal gestation who were evaluated at gestational week 30, 6 weeks and 6 months postpartum. Circulating adipokines that were evaluated during the study were leptin, adiponectin, retinol-binding protein-4 (RBP4), and tumor necrosis factor-alpha (TNF-α).
  
  
  RESULTS
  Women with GDM showed higher insulin resistance measured by HOMA-IR than subjects with normal gestation (2.3 ± 2.3 vs. 1.3 ± 0.95). There was no difference between groups in adipokines; however, in women with a healthy pregnancy, RBP4 was associated with insulin resistance (r = 0.47, p <0.05). At 6 weeks and 6 months postpartum, women with previous GDM exhibited persistent elevated leptin and insulin resistance. RBP4 was associated with insulin resistance only in women with a previous healthy pregnancy (r = 0.51, p <0.05). In addition, progressively impaired glucose tolerance was observed after delivery in women with previous GDM.
  
  
  CONCLUSIONS
  It was demonstrated that GDM is associated with greater insulin resistance than observed in normal pregnancy; however, adipokines are similar in both groups. RBP4 levels are significantly associated with insulin resistance in healthy women during pregnancy and postpartum. After a pregnancy complicated by GDM, leptin and insulin resistance remain elevated and glucose tolerance worsens.
authors.affiliation: Endocrine Research Unit, National Medical Center, Mexican Social Security Institute, Mexico City, Mexico. sgrenata@yahoo.com
authors.forename: Renata
authors.initials: R
authors.lastname: Saucedo
authors.forename: Arturo
authors.initials: A
authors.lastname: Zarate
authors.forename: Lourdes
authors.initials: L
authors.lastname: Basurto
authors.forename: Marcelino
authors.initials: M
authors.lastname: Hernandez
authors.forename: Edgardo
authors.initials: E
authors.lastname: Puello
authors.forename: Rosa
authors.initials: R
authors.lastname: Galvan
authors.forename: Sandra
authors.initials: S
authors.lastname: Campos
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011446:Prospective Studies; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D054392:Adipokines; D052242:Adiponectin; D001786:Blood Glucose; D020738:Leptin; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D014409:Tumor Necrosis Factor-alpha