Serum adiponectin during pregnancy and postpartum in women with gestational diabetes and normal controls

Abstract

GDM is associated with decreased serum adiponectin levels both in pregnancy as well as postpartum. Adiponectin is negatively correlated to HOMA-IR. A reduction in maternal adiponectin after delivery indicates a significant placental contribution to adiponectin production.

Alterations in circulating adiponectin levels occur rapidly after parturition

“…In our study, significantly decreasing adiponectin levels were observed uniformly shortly after the removal of the placenta. A similar decrease in adiponectin levels was implied in a study that compared adiponectin levels around gestational week 30 with postpartum levels within 5 days of delivery, though the decrease was significant only among women who were diagnosed with gestational diabetes, whereas the decrease in the non-diabetic control group was insignificant (18). Taken together, a placental contribution to the circulating pool of adiponectin could be speculated, though only indirectly suggested by the present results.…”

“…In extension of and in context with the immediate changes in maternal adiponectin levels reported here, previous works on adiponectin levels in the puerperium have reported levels lower than or comparable to third trimester levels from a few days to 6 months after delivery, even in women who had stopped breastfeeding (10,17,18,(21)(22)(23). Shortly after delivery, fasting insulin levels decline dramatically as demonstrated for this cohort also (13,23).…”

“…Singletons for subform analysis (nZ19) Supporting previous data, a statistically significant association was found between circulating third trimester adiponectin levels and estimates of insulin sensitivity, and this relationship was further strengthened using the ratio of HMW to total adiponectin rather than total concentrations (2,16,18). Late pregnancy is a state of insulin resistance, and these observations further add to the evidence of a role for especially HMW adiponectin in determining insulin resistance (19).…”

The Role of Adipocyte Mediators, Inflammatory Markers and Vitamin D in Gestational Diabetes

“…In another study, class A2 and B gestational diabetes are associated with a suppressed level of adiponectin (Thyfault et al, 2005 ). To investigate changes in serum adiponectin during pregnancy and postpartum and assess its relationship with insulin resistance as measured by homeostasis model assessment (HOMA-IR) a study was done and revealed adiponectin was lower in gestational diabetes than in control groups during pregnancy and a significant post reduction in adiponectin was observed in maternal adiponectin after delivery indicating a significant placental contribution to adiponectin production (Vitoratos et al, 2008). The result of the another study identified weight gain as the strongest factor associated with declining cell compensation for insulin resistance in Hispanic women at high risk for type 2 diabetes.…”

Immunohistochemical and Morphometrical Study of Gestational Induced Changes in Mouse Liver Using Anti-Adiponectin Receptor 2.

“…In addition, adiponectin levels correlate with whole body insulin sensitivity, because of the insulin sensitizing effects of adiponectin in muscle and liver, adiponectin reduces hepatic glucose production and enhances insulin action in the liver and peripheral utilization of glucose. (25) The marked increase of circulating adiponectin with relatively little benefit in people with T1D indicates a breakdown of the adiponectin signaling pathway .In nonobese diabetic (NOD) mice, an autoimmune model of T1D, the loss of adiponectin signaling in the liver is evident from the reduction of SOGA, Insulin injection eliminates hyperglycemia in NOD mice without correcting the deficiency of SOGA. TZD drugs currently prescribed for the treatment of insulin resistance in T1D may work by stimulating the production of adiponectin and SOGA.…”