title: Leptin and adiponectin as predictors of cardiovascular risk after gestational diabetes mellitus.
abstract: Gestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. Adipokine imbalance in the presence of metabolic dysfunction may be a key event in promoting CVD. The aim of the study was to examine the relationships between GDM, cardiovascular risk, and plasma adiponectin, leptin and the leptin/adiponectin (L/A) ratio in pregnancy and at 5 years after the index pregnancy.
  
  
  
  This population-based prospective cohort included 300 women who had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy X-ray absorptiometry, lipid analysis, and pulse wave velocity analysis. Fasting adiponectin and leptin levels were measured four times during pregnancy and at follow-up.
  
  
  
  We found the L/A ratio higher in GDM women both during pregnancy and follow-up compared to non-GDM women. A high L/A ratio during pregnancy was associated with CV risk based on lipid ratios at follow-up, especially the TG/HDL-C ratio. Further, interaction analysis indicated that an increase in the L/A ratio of 1 unit was associated with a higher CV risk in GDM compared to normal pregnancy. Finally, low adiponectin levels independently predicted increased lipid ratios at follow-up.
  
  
  
  Taken together, our findings suggest that high L/A ratio in pregnancy and in particularly in those with GDM are associated with an unfavorable CVD risk profile during follow-up. Future studies should investigate if a dysregulated leptin and adiponectin profile during pregnancy is associated with atherosclerotic disease during long-term follow-up.
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. tove.lekva@rr-research.no.
authors.forename: Tove
authors.identifier: 0000-0002-7962-4726
authors.initials: T
authors.lastname: Lekva
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Annika Elisabet
authors.initials: AE
authors.lastname: Michelsen
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.|K. G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.affiliation: Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Henriksen
authors.affiliation: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.|K. G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
mesh_terms: D015502:Absorptiometry, Photon; D052242:Adiponectin / Q000097:blood*; D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D020738:Leptin / Q000097:blood*; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin; D008055:Lipids
keywords: Adiponectin; CVD; GDM; Leptin