Circulating chemerin levels and gestational diabetes mellitus: a systematic review and meta-analysis

Abstract

BackgroundChemerin is a novel adipokine which is associated with metabolic syndrome and type 2 diabetes mellitus. However, recent investigations regarding circulating chemerin levels in gestational diabetes mellitus (GDM) are conflicting. This meta-analysis is to evaluate and determine their associations.MethodsA systematic literature search was performed in PubMed, EMBASE and Web of Science up to 13 December 2017. Pooled standardized mean differences (SMD) and 95% confidence interval (CI) were calculated using a random-effect model.ResultsEleven studies comprising 742 GDM patients and 840 normal pregnant women were included. Circulating chemerin levels were increased in GDM patients compared with healthy pregnant women (SMD: 1.16; 95% CI: 0.29, 2.04; P = 0.009). Subgroup analyses revealed such difference was especially available in the groups of the second trimester (SMD: 1.47; 95% CI: 0.28, 2.67) and mean age < 30 years (SMD: 2.30; 95% CI: 0.69, 3.91) of GDM patients. There was significant heterogeneity among studies (I2 = 98.0%, P < 0.001); however, heterogeneity disappeared or markedly decreased in the subgroups of European populations (I2 = 0.0%, P = 0.531), age ≥ 30 years (I2 = 28.2%, P = 0.223) and WHO diagnostic criteria (I2 = 0.0%, P = 0.490) when stratifying by study location, trimester of chemerin measurement and the diagnostic criteria of GDM.ConclusionsThe elevated levels of circulating chemerin were associated with GDM, which suggests it might play an important role in the pathogenetic mechanism of GDM.

Circulating apelin, chemerin and omentin levels in patients with gestational diabetes mellitus: a systematic review and meta-analysis

“…The finding in this meta-analysis that circulating chemerin levels were similar in women with GDM and in normal pregnant women is consistent with previous studies [8,23]. Unlike Zhou et al, this meta-analysis took ethnicity, diagnostic criteria, and sample size into account [41]. Sub-analysis revealed that Asian and African women, patients younger than 30 years of age, those with BMIs ≥28 kg/m 2 , or those diagnosed using the ACOG criteria in the second trimester had higher circulating chemerin levels than controls.…”

Adipokines and macrophage markers during pregnancy—Possible role for sCD163 in prediction and progression of gestational diabetes mellitus

“…In contrast to several studies presenting elevated levels in chemerin between GDM and non‐GDM, also in early pregnancy, and presented in a recent meta‐analysis, we found similar levels in these groups. However, chemerin was correlated with BMI as well as insulin resistance/sensitivity in both early and late pregnancy, supporting a role for this protein in normal glucose homeostasis.…”

Involvement of Novel Adipokines, Chemerin, Visfatin, Resistin and Apelin in Reproductive Functions in Normal and Pathological Conditions in Humans and Animal Models

“…Contrary to normal pregnancy, which is associated with increased plasma chemerin levels that decrease post-partum, Hare et al showed that circulating chemerin was reduced in GDM women and did not change with the normalisation of glucose tolerance following delivery [228] (Figure 13). However, a recent meta-analysis by Zhou et al, evaluating 11 studies carried out between 2010 and 2017 and including a total of 742 GDM patients and 840 normal pregnant women [229], reported that the overall levels of plasma chemerin in GDM women were significantly increased when compared with healthy pregnant ones and that this difference was more evident in the second- than in the third-trimester. The authors thus concluded that chemerin may play a powerful role in the pathophysiology of GDM by increasing IR and promoting subclinical inflammation [229] (Figure 13).…”

“…However, a recent meta-analysis by Zhou et al, evaluating 11 studies carried out between 2010 and 2017 and including a total of 742 GDM patients and 840 normal pregnant women [229], reported that the overall levels of plasma chemerin in GDM women were significantly increased when compared with healthy pregnant ones and that this difference was more evident in the second- than in the third-trimester. The authors thus concluded that chemerin may play a powerful role in the pathophysiology of GDM by increasing IR and promoting subclinical inflammation [229] (Figure 13). These results are, however, contradicted by a previous review, evaluating various adipokines in GDM, which demonstrated that adiponectin, leptin and TNF-alpha are more likely than chemerin, resistin and visfatin to play a role in the pathogenic mechanism of GDM [230] (Figure 13).…”

“…Noteworthy, very recently, another component of the apelin-APJ system, named elabela has been postulated to be actively involved in PE development. Indeed, elabela is a new endogenous peptide ligand for the APJ receptor, which seems to play a crucial role in embryonic development [229]. Ho et al demonstrated that deletion of the elabela gene in mice caused PE-like symptoms and that the administration of elabela to pregnant elabela -null mice prevented the increase in maternal blood pressure, proteinuria and FGR [264].…”