Regulation of the novel adipokines/ hepatokines fetuin A and fetuin B in gestational diabetes mellitus.
Fetuin B has recently been introduced as a novel adipokine/hepatokine which is significantly increased in hepatic steatosis and mediates impaired insulin action, as well as glucose intolerance. However, regulation of fetuin B in gestational diabetes mellitus (GDM), as well as its longitudinal changes in the peripartum period, have not been elucidated, so far.



Circulating fetuin A and fetuin B were quantified in 74 women with GDM and 74 healthy and gestational age-matched controls by enzyme-linked immunosorbent assay during pregnancy (median gestational age: 201days). Furthermore, fetuin B was quantified during pregnancy as compared to postpartum levels in a follow-up study (median time after delivery: 4years and 115days).



Median [interquartile range] serum fetuin B levels were significantly higher in women with GDM (4.8 [1.7] mg/l) as compared to non-diabetic pregnant controls (4.3 [1.2] mg/l) (p=0.013) during pregnancy. In multivariate analysis, GDM status, insulin resistance, and fetuin A were independent and positive predictors of circulating fetuin B. Furthermore, fetuin B serum concentrations significantly decreased after delivery from 4.6 [1.7] mg/l (prepartum) to 3.0 [2.2] mg/l (postpartum) in all women (p<0.001).



Women with GDM have significantly higher fetuin B levels as compared to healthy pregnant control women and GDM status, insulin resistance, and fetuin A positively predict circulating fetuin B. Postpartum fetuin B is decreased as compared to prepartum values suggesting a placental co-secretion of this novel adipokine/hepatokine. Further studies need to elucidate factors contributing to fetuin B regulation in humans, as well as the pathophysiological significance of fetuin B upregulation in GDM.
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany.
Susan
S
Kralisch
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany.
Annett
A
Hoffmann
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany.
Ulrike
U
Lössner
University of Leipzig, Institute of Laboratory Medicine, 04103 Leipzig, Germany.
Jürgen
J
Kratzsch
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany.
Matthias
M
Blüher
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany.
Michael
M
Stumvoll
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany.
Mathias
M
Fasshauer
University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany. Electronic address: Thomas.ebert@medizin.uni-leipzig.de.
Thomas
T
Ebert
D054392:Adipokines / Q000378:metabolism*; D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D060752:Fetuin-B / Q000378:metabolism*; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D058725:Peripartum Period / Q000378:metabolism; D011247:Pregnancy; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
C556354:AHSG protein, human; D054392:Adipokines; D001786:Blood Glucose; C504687:FETUB protein, human; D060752:Fetuin-B; D007328:Insulin; D060749:alpha-2-HS-Glycoprotein
Adipokine; Fetuin B; Gestational diabetes mellitus; Hepatokine; Insulin resistance