title: Adiponectin and IGFBP-1 in the development of gestational diabetes in obese mothers.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) is more common in pregnancies complicated by obesity and both diseases increase the risk for fetal overgrowth and long-term adverse health consequences for the mother and child. Previous studies have linked low maternal serum adiponectin to GDM in normal and overweight women. We hypothesized that lower adiponectin, in particular the high-molecular-weight form, and insulin-like growth factor I (IGF-I) and its binding protein (IGFBP-1) are associated with GDM in pregnant obese Hispanic women.
  
  
  METHODS
  72 obese, predominantly Hispanic (92%), women were recruited at 24-28 weeks of gestation. Adiposity was assessed, fasting serum samples were collected, and glucose, insulin, triglyceride, cholesterol levels, adipokines, and hormones associated with obesity and insulin resistance were measured. 30 women had been recently diagnosed with GDM.
  
  
  RESULTS
  Gestational weeks, body mass index, triceps skinfold thickness, mid-arm circumference, serum leptin, IGF-I, tumor necrosis factor α, and interleukin-6 did not differ in the two groups. Obese women with GDM had significantly higher fasting glucose, A1C, triglycerides, very-low-density lipoprotein cholesterol and lower high-density lipoprotein cholesterol, adiponectin, and IGFBP-1 compared to obese women without GDM. Homeostasis model assessment of insulin resistance was positively correlated to IGF-I and negatively correlated to adiponectin.
  
  
  CONCLUSIONS
  Obese pregnant women with recently diagnosed GDM had a significantly exacerbated metabolic profile, low serum adiponectin and IGFBP-1 levels at 24-28 weeks of gestation, as compared to women with obesity alone. Because low adiponectin is well established to cause insulin resistance and decreased IGFBP-1 indicates increased IGF-I bioavailability, we propose that these changes are mechanistically linked to the development of GDM in obese Hispanic women.
authors.affiliation: Department of Obstetrics and Gynecology , Center for Pregnancy and Newborn Research, University of Texas Health Science Center at San Antonio , San Antonio, Texas , USA.
authors.forename: Vanessa I
authors.initials: VI
authors.lastname: Ramirez
authors.affiliation: Department of Obstetrics and Gynecology , Center for Pregnancy and Newborn Research, University of Texas Health Science Center at San Antonio , San Antonio, Texas , USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Miller
authors.affiliation: Department of Obstetrics and Gynecology , Center for Pregnancy and Newborn Research, University of Texas Health Science Center at San Antonio , San Antonio, Texas , USA.
authors.forename: Christiane L
authors.initials: CL
authors.lastname: Meireles
authors.affiliation: Department of Biostatistics and Epidemiology , University of Texas Health Science Center at San Antonio , San Antonio, Texas , USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gelfond
authors.affiliation: Department of Nutritional Sciences , University of Cincinnati Academic Health Center , Cincinnati, Ohio , USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Krummel
authors.affiliation: Department of Obstetrics and Gynecology , Center for Pregnancy and Newborn Research, University of Texas Health Science Center at San Antonio , San Antonio, Texas , USA.
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Powell
keywords: Adiponectin; Gestational Diabetes Mellitus; Obesity; Pregnancy