Maternal Serum Visfatin at 11–13 Weeks of Gestation in Gestational Diabetes Mellitus

Abstract

BACKGROUND Visfatin and adiponectin are produced by adipose tissue and have opposite effects on insulin resistance. Circulating concentrations of these biomarkers are altered in type 2 diabetes mellitus. We sought to examine the potential value of maternal serum visfatin and adiponectin concentrations in early pregnancy as potential biomarkers in the prediction of gestational diabetes mellitus (GDM). METHODS This work was a case-control study of 100 women who developed GDM and 300 nondiabetic controls. Maternal serum visfatin and adiponectin were measured between 11 and 13 weeks of gestation. Regression analysis in the nondiabetic group was performed to examine the maternal characteristics affecting the serum concentrations of visfatin and adiponectin. Likelihood ratios for GDM were calculated for visfatin and adiponectin, and performance of screening was assessed by using ROC curve analysis. RESULTS In the GDM group compared with the nondiabetic group, the median maternal serum visfatin concentration was increased (1.34 multiples of the median [MoM], interquartile range [IQR] 0.70–2.87, vs 1.00 MoM, IQR: 0.53–1.92; P = 0.004) and serum adiponectin was decreased (0.66 MoM, IQR 0.50–0.92, vs 1.01, IQR 0.70–1.29; P < 0.0001). In screening for GDM by a combination of maternal factors and serum adiponectin and visfatin, the estimated detection rate was 68.0% (95% CI 58.3–76.3%), at a false-positive rate of 10%. CONCLUSIONS At 11–13 weeks in pregnancies that develop GDM, the serum concentration of adiponectin is decreased and visfatin is increased, and these biomarkers can be combined with maternal factors to provide effective early screening for GDM.

First-trimester multimarker prediction of gestational diabetes mellitus using targeted mass spectrometry

“…Of the 29 potential protein biomarkers, adiponectin is the best studied in relation to GDM [11][12][13][14]16]. Here, adiponectin was the best performing independent predictor of GDM, regardless of BMI grouping.…”

“…This could be an important tool in future screening strategies to ensure that women at the highest risk undergo a diagnostic OGTT at gestational week 24-28. At present, no serum biomarker with clinical utility has been identified and the potential utility in GDM screening has been investigated for only a limited number of proteins. Adiponectin is by far the best-studied protein biomarker for GDM but lacks the sensitivity and specificity required for clinical use [11][12][13][14][15][16]. Other proteins such as sex hormone binding protein (SHBG), retinol-binding protein 4 (RBP-4), resistin and C-reactive protein (CRP) have also been investigated as potential biomarkers of GDM, but conclusions have been variable [14,[17][18][19][20][21][22][23].…”

Związek hormonów pochodzących z tkanki tłuszczowej z cukrzycą ciążową (GDM)

“…For example, Krzyzanowska et al [82] reported markedly higher plasma visfatin concentration in GDM women compared to NGT pregnant controls; however, there was no relationship between visfatin and fasting plasma glucose, plasma insulin, insulin resistance, and BMI. Elevated plasma visfatin concentration in GDM women has also been demonstrated by others [83,84]. Lewandowski et al [83] revealed positive correlations of plasma visfatin levels with concentrations of both fasting and post-glucose-load insulin in GDM women in the third trimester of pregnancy.…”

“…Lewandowski et al [83] revealed positive correlations of plasma visfatin levels with concentrations of both fasting and post-glucose-load insulin in GDM women in the third trimester of pregnancy. Ferreira et al [84] reported an increased plasma visfatin level in the first trimester of pregnancy in women who developed GDM, suggesting that visfatin could be a potential biomarker for predicting GDM. In contrast, a reduced plasma visfatin level, by approx.…”

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“…La visfatina está relacionada con el metabolismo de las HDL y existen reportes de su incremento en diabetes gestacional tipo 1 y tipo 2 y obesidad gestacional (17). Adicionalmente, se han encontrado incrementadas las concentraciones de visfatina séricas en el primer trimestre de la gestación en mujeres que desarrollaron preeclampsia por un mecanismo no relacionado a la perfusión placentaria alterada, y en mujeres que presentaron diabetes gestacional (19,20).…”