title: Adiponectin, C-reactive protein, fibrinogen and tissue plasminogen activator antigen levels among glucose-intolerant women with and without histories of gestational diabetes.
abstract: OBJECTIVE
  To examine concentrations of biomarkers (adiponectin, C-reactive protein, fibrinogen and tissue plasminogen-activator antigen) associated with glucose homeostasis and diabetes risk by history of gestational diabetes (GDM).
  
  
  METHODS
  We conducted a secondary analysis of the Diabetes Prevention Program, a randomized trial of lifestyle intervention or metformin for diabetes prevention. At baseline, participants were overweight and had impaired glucose tolerance. Biomarkers at baseline and 1 year after enrolment were compared between parous women with (n = 350) and without histories of GDM (n = 1466). Cox proportional hazard models evaluated whether history of GDM was associated with diabetes risk, after adjustment for baseline biomarker levels as well as for change in biomarker levels, demographic factors and anthropometrics.
  
  
  RESULTS
  At baseline, women with histories of GDM had lower adiponectin (7.5 μg/ml vs. 8.7 μg/ml; p < 0.0001) and greater log C-reactive protein (-0.90 mg/l vs. -0.78 mg/l, p = 0.04) levels than women without histories of GDM, but these associations did not persist after adjustment for demographic factors. Fibrinogen and tissue plasminogen-activator antigen were similar between women with and without histories of GDM. Women with and without histories of GDM had a similar pattern of changes in biomarkers within randomization arm. Adjustment for age, race/ethnicity, baseline weight, change in weight, baseline biomarker level and change in biomarker level did not significantly alter the association between history of GDM, and diabetes risk.
  
  
  CONCLUSIONS
  Among women with impaired glucose tolerance, biomarkers in women with and without histories of GDM are similar and respond similarly to lifestyle changes and metformin. Adjustment for biomarker levels did not explain the higher risk of diabetes observed in women with histories of GDM.
authors.affiliation: Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.affiliation: Biostatistics Center, George Washington University, Rockville, MD, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Christophi
authors.affiliation: Department of Medicine, University of Miami, Miami, FL, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Goldberg
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: L
authors.initials: L
authors.lastname: Perreault
authors.affiliation: Department of Preventive Medicine and Biometrics, Colorado School of Public Health, Aurora, CO, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Marcovina
authors.affiliation: Division of Endocrinology, Columbia University Medical Center, New York City, NY, USA.
authors.forename: X
authors.initials: X
authors.lastname: Pi-Sunyer
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, CA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Barrett-Connor
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D016640:Diabetes, Gestational / Q000503:physiopathology*; D004038:Diet, Reducing; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D018149:Glucose Intolerance / Q000097:blood* / Q000150:complications / Q000209:etiology / Q000628:therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008875:Middle Aged; D009043:Motor Activity; D050177:Overweight / Q000150:complications / Q000628:therapy*; D011247:Pregnancy; D012306:Risk; D010959:Tissue Plasminogen Activator / Q000097:blood*; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D007004:Hypoglycemic Agents; D005340:Fibrinogen; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator