Endocrine Abstracts

Aim: Hypoadiponectinemia is known to be associated with insulin resistance, diabetes and obesity. Since gestational diabetes is together with increased body mass index (BMI) and decreased insulin sensitivity, the evaluation of adiponectin levels in these patients is interesting. We investigated the relationship between adiponectin and glucose tolerance during pregnancy and after delivery.

Materials and methods: We evaluated plasma adiponectin levels, insulin resistance and glucose tolerance in women with gestational diabetes mellitus (GDM, n=16) and in normal pregnancies (controls, n=18). Measurements were performed two times as in 28–31 weeks of pregnancy and at 3 months after delivery. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR).

Results: Four of the GDM patients remained as impaired glucose tolerance after delivery. Adiponectin levels during pregnancy were significantly lower in women with GDM compared to normal pregnancies (7.68±6.26 μg/ml vs 12.72±3.72 μg/ml; P<0.01). Adiponectin levels increased significantly after delivery both in GDM and control groups. Despite the increment after delivery, adiponectin remained significantly lower in women with GDM compared to controls (11.75±6.11 μg/ml vs 16.55±3.05 μg/ml; P<0.01). In HOMA-IR, the differences between two groups before and after delivery, and also the changes with delivery within the groups, were not found statistically significant. Adiponectin was correlated negatively with HOMA-IR (r=−0.39, P<0.05), third-trimester BMI (r=−0.37, P<0.05) and one-hour plasma glucose (r=−0.33, P<0.05); and positively with HDL-cholesterol (r=0.34, P<0.05) in women with GDM. These correlations including the adiponectin-HOMA-IR one disappeared following the delivery.

Conclusion: Decreased adiponectin levels in GDM do not normalise instantaneously following the delivery. The difference is more apparent in adiponectin levels than in HOMA-IR. There is a moderate correlation between adiponectin and one-hour plasma glucose in GDM.