Gestational Diabetes Mellitus Causes Changes in the Concentrations of Adipocyte Fatty Acid–Binding Protein and Other Adipocytokines in Cord Blood

Abstract

OBJECTIVETo determine the concentrations of adipocyte fatty acid–binding protein (AFABP) and other adipocytokines in maternal and cord serum of pregnant women with gestational diabetes mellitus (GDM) and of control subjects and to relate them to indexes of insulin sensitivity.RESEARCH DESIGN AND METHODSIn 86 control and 98 GDM pregnant women, venous blood was collected before vaginal delivery and arterial blood from cord immediately after delivery. Serum insulin and adipocytokines were measured by enzyme-linked immunosorbent assay (ELISA).RESULTSGDM women had higher prepregnancy BMI, and data were adjusted for it. Maternal serum insulin, insulin-to-glucose ratio, homeostasis model assessment (HOMA), AFABP, and retinol-binding protein 4 (RBP4) were higher and adiponectin was lower in GDM than in control subjects, whereas serum glucose, insulin, insulin-to-glucose ratio, HOMA, nonesterified fatty acids, and RBP4 were higher and glycerol, AFABP, and adiponectin were lower in cord blood serum of GDM than of control subjects. AFABP and adiponectin in cord serum of control subjects were higher than in maternal serum; in GDM women no difference was found for AFABP in cord versus maternal serum, although adiponectin remained higher in cord. Values of leptin in both groups were lower in cord than in maternal serum, and those of RBP4 were lower in only GDM women.CONCLUSIONSIt is suggested that fetal tissues are the main source of cord arterial serum AFABP, and in GDM fetuses AFABP values correlate with adiposity markers. A downregulation of adiponectin and upregulation of RBP4 in GDM mothers and their fetuses may be related to their insulin-resistant condition, whereas changes in AFABP do not seem to be related.

Gestational Diabetes and the Offspring: Implications in the Development of the Cardiorenal Metabolic Syndrome in Offspring

“…This finding suggests that leptin in the umbilical cord originates and reflects the fetal nutrition status. In GDM, the leptin data are even more interesting: leptin levels in the cord serum of neonates are increased in comparison to controls [25]. The same observations have been reproduced in studies with ewes, where leptin mRNA from fetal adipose tissue was positively correlated with hyperinsulinemia [34].…”

“…In the same study, Ortega-Senovilla et al [25 ]demonstrated that maternal serum adiponectin in GDM was decreased (p < 0.001) in comparison to the control group. They also observed a similar decrease in adiponectin in the cord blood of mothers with GDM when compared to the control group [25]. The role of adiponectin in pregnancy is unclear.…”

“…The role of adipocytokines such as leptin, adiponectin, adipocyte fatty acid-binding protein (AFABP), and retinol-binding protein 4 (RBP4) in maintaining this balance of glucose between the mother and the fetus is still unclear, but animal model studies suggest that adipocytokines modulate the secretion of insulin in the maternal-fetal unit [25]. In GDM, an imbalance in the interplay between these adipocytokines and insulin secretion seems to be one of the reasons for the augmented insulin resistance in this disease.…”

Changes in serum adipocyte fatty acid‐binding protein in women with gestational diabetes mellitus and normal pregnant women during mid‐ and late pregnancy

“…We know of few studies where the level of AFABP in GDM women has been determined11, 12, 13, and results have been contradictory. For example, it has not been well documented whether AFABP is associated with the pathogenesis of GDM.…”

Metabolic disorder of pregnancy (understanding pathophysiology of diabetes and preeclampsia)

“…This adipokine is a protein responsible for intracellular fatty acid transfer and it also plays a role in the regulation of hormone-sensitive lipase activity [37]. Maternal serum levels of AFABP show a strong association with maternal prepregnancy BMI in both normal-glycemic women and GDM women [38]. Other adipokines also secreted by adipose tissue have been reported to modulate the insulin response such as leptin and adiponectin [39], but it is beyond the scope of this short review to discuss their contribution in any detail.…”