title: Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus.
abstract: OBJECTIVE
  To evaluate the associations between adiponectin levels and 1) the risk of developing gestational diabetes mellitus (GDM), and 2) insulin resistance/sensitivity, β-cell function, and compensation indices in a prospective cohort representative of the general population of pregnant women.
  
  
  METHODS
  We performed anthropometric measurements and collected blood samples at 1st (6-13 weeks) and 2nd (24-28 weeks) trimesters. Diagnosis of GDM was made at 2nd trimester based on a 75-g oral glucose tolerance test (International Association of the Diabetes and Pregnancy Study Groups criteria). Insulin was measured (ELISA; Luminex) to estimate homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-B), insulin sensitivity (Matsuda index), insulin secretion (AUC(insulin/glucose)), and β-cell compensation (insulin secretion sensitivity index-2). Adiponectin was measured by radioimmunoassay.
  
  
  RESULTS
  Among the 445 participants included in this study, 38 women developed GDM. Women who developed GDM had lower 1st-trimester adiponectin levels (9.67 ± 3.84 vs. 11.92 ± 4.59 µg/mL in women with normal glucose tolerance). Lower adiponectin levels were associated with higher risk of developing GDM (OR, 1.12 per 1 µg/mL decrease of adiponectin levels; P = 0.02, adjusted for BMI and HbA1c at 1st trimester). Adiponectin levels at 1st and 2nd trimesters were associated with HOMA-IR (both: r = -0.22, P < 0.0001) and Matsuda index (r = 0.28, P < 0.0001, and r = 0.29, P < 0.0001). After adjustment for confounding factors, we found no significant association with HOMA-B and AUC(insulin/glucose).
  
  
  CONCLUSIONS
  Pregnant women with lower adiponectin levels at 1st trimester have higher levels of insulin resistance and are more likely to develop GDM independently of adiposity or glycemic measurements.
authors.affiliation: Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Lacroix
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Battista
authors.forename: Myriam
authors.initials: M
authors.lastname: Doyon
authors.forename: Julie
authors.initials: J
authors.lastname: Ménard
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Ardilouze
authors.forename: Patrice
authors.initials: P
authors.lastname: Perron
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Hivert
mesh_terms: D052242:Adiponectin / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin