title: Elevated plasma SPARC levels are associated with insulin resistance, dyslipidemia, and inflammation in gestational diabetes mellitus.
abstract: OBJECTIVE
  Recent studies suggested that secreted protein acidic and rich in cysteine (SPARC), a novel adipokine, is a key player in the pathology of obesity and type 2 diabetes. We aimed to determine whether concentrations of SPARC were altered in patients with gestational diabetes mellitus (GDM) compared to normal glucose tolerance (NGT) controls and to investigate the relationships between SPARC and metabolic parameters in pregnant women.
  
  
  METHODS
  Cross-sectional study of 120 pregnant women with GDM and 60 controls with NGT, in a university hospital setting. Plasma levels of SPARC, adiponectin, fibroblast growth factor 21 (FGF21), insulin and proinsulin were determined by ELISA.
  
  
  RESULTS
  GDM women had higher SPARC and lower adiponectin than NGT subjects; no difference was found in FGF21. SPARC levels were the lowest in subjects in the third tertile of insulin sensitivity index (ISIOGTT) and correlated positively with pre-pregnant BMI, insulin and 3 h glucose during 100-g OGTT, HOMA-IR, fasting proinsulin, hsCRP and white blood cells count, and negatively with ISIOGTT, when adjusting for gestational age. Triglyceride (TG), Apolipoprotein A1, apolipoprotein B and lipoprotein (a) correlated with SPARC in partial Pearson correlation. Correlations between SPARC with adiponectin, systolic blood pressure and TG were marginally significant in partial Spearman correlation analysis. In multivariate regression analysis, SPARC was an independent negative indicator of ISIOGTT.
  
  
  CONCLUSIONS
  SPARC levels are correlated significantly with inflammation and may also be correlated with dyslipidemia and represent an independent determinant of insulin resistance in late pregnancy, indicating a potential role of SPARC in the pathophysiology of GDM.
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Ping
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Yin
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Xiao
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Hongding
authors.initials: H
authors.lastname: Xiang
authors.affiliation: Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America ; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, Texas, United States of America.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America.
authors.forename: Huaizhu
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D052242:Adiponectin / Q000097:blood / Q000235:genetics; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D016640:Diabetes, Gestational / Q000097:blood* / Q000235:genetics / Q000473:pathology; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications / Q000235:genetics / Q000473:pathology; D005215:Fasting; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood / Q000235:genetics; D015870:Gene Expression; D005865:Gestational Age; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000235:genetics / Q000473:pathology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015676:Osteonectin / Q000097:blood* / Q000235:genetics; D011247:Pregnancy; D011384:Proinsulin / Q000097:blood; D014280:Triglycerides / Q000097:blood
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D015676:Osteonectin; C577241:SPARC protein, human; D014280:Triglycerides; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors; D011384:Proinsulin