title: Are third-trimester adipokines associated with higher metabolic risk among women with gestational diabetes?
abstract: OBJECTIVE
  This study aimed to determine whether third-trimester adipokines during gestational diabetes (GDM) are associated with higher metabolic risk.
  
  
  METHODS
  A total of 221 women with GDM (according to IADPSG criteria) were enrolled between 2011/11 and 2013/6 into a prospective observational study (IMAGE), and categorized as having elevated fasting blood glucose (FBG) or impaired fasting glucose (IFG, n = 36) if levels were ≥ 92 mg/dL during a 75-g oral glucose tolerance test (OGTT), impaired glucose tolerance (IGT, n = 116) if FBG was < 92 mg/dL but with elevated 1-h or 2-h OGTT values, or impaired fasting and stimulated blood glucose (IFSG, n = 69) if both FBG was ≥ 92 mg/dL and 1-h or 2-h OGTT values were elevated.
  
  
  RESULTS
  Pre-gestational body mass index (BMI) was higher in women with IFG or IFSG compared with IGT (P < 0.001), as were leptin levels in women with IFG vs IGT [34.7 (10.5-119.7) vs 26.6 (3.56-79.4) ng/L; P = 0.008]. HOMA2-IR scores were higher in women with IFG or IFSG vs IGT (1.87 ± 1.2 or 1.72 ± 0.9 vs 1.18 ± 0.8, respectively; P < 0.001). Also, those with IFSG vs those with IGT had significantly lower HOMA2-B scores (111.4 ± 41.3 vs 127.1 ± 61.6, respectively; P < 0.05) and adiponectin levels [5.00 (1.11-11.3) vs 6.19 (2.11-17.7) μg/mL; P < 0.001], and higher levels of IL-6 [1.14 (0.33-20.0) vs 0.90 (0.31-19.0); P = 0.012] and TNF-α [0.99 (0.50-10.5) vs 0.84 (0.45-11.5) pg/mL; P = 0.003]. After adjusting for age, parity, and pre-gestational and gestational BMI, the difference in adiponectin levels remained significant.
  
  
  CONCLUSIONS
  Diagnosing GDM by IADSPG criteria results in a wide range of heterogeneity. Our study has indicated that adipokine levels in addition to FBG may help to select women at high metabolic risk for appropriate monitoring and post-delivery interventions (ClinicalTrials.gov number NCP02133729).
authors.affiliation: Department of Endocrinology and Diabetes, Lyon-Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Benite, France.
authors.forename: D
authors.initials: D
authors.lastname: Honnorat
authors.affiliation: Department of Endocrinology and Diabetes, Lyon-Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Benite, France; Claude Bernard University Lyon I, Lyon, France; CARMEN-Inserm U1060, Université Claude-Bernard Lyon 1, Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Disse
authors.affiliation: Department of Endocrinology, North Hospital, Saint-Étienne, France.
authors.forename: L
authors.initials: L
authors.lastname: Millot
authors.affiliation: Claude Bernard University Lyon I, Lyon, France; Hospices Civils de Lyon, Pôle IMER, Unité de recherche clinique, 69003 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Mathiotte
authors.affiliation: Department of Endocrinology and Diabetes, Lyon-Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Benite, France.
authors.forename: M
authors.initials: M
authors.lastname: Claret
authors.affiliation: Claude Bernard University Lyon I, Lyon, France; Department of Biochemistry, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Charrie
authors.affiliation: Department of Biochemistry, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Drai
authors.affiliation: Department of Biochemistry, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Garnier
authors.affiliation: Hospices Civils de Lyon, Pôle IMER, Unité de recherche clinique, 69003 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Maurice
authors.affiliation: Hospices Civils de Lyon, Pôle IMER, Unité de recherche clinique, 69003 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Durand
authors.affiliation: Department of Endocrinology and Diabetes, Lyon-Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Benite, France; Claude Bernard University Lyon I, Lyon, France; CARMEN-Inserm U1060, Université Claude-Bernard Lyon 1, Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Simon
authors.affiliation: Department of Gynecology and Obstetrics, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Dupuis
authors.affiliation: Department of Endocrinology and Diabetes, Lyon-Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Benite, France; Claude Bernard University Lyon I, Lyon, France; CARMEN-Inserm U1060, Université Claude-Bernard Lyon 1, Lyon, France. Electronic address: charles.thivolet@chu-lyon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Thivolet
mesh_terms: D052242:Adiponectin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D050177:Overweight / Q000503:physiopathology*; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin
keywords: Adipokines; Cytokines; Gestational diabetes; Metabolic syndrome; Screening