Association Between Adiponectin and Tumor Necrosis Factor-Alpha Levels at Eight to Fourteen Weeks Gestation and Maternal Glucose Tolerance: The Parity, Inflammation, and Diabetes Study
1 Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine , Chapel Hill, North Carolina. Journal of Women's Health
(Impact Factor: 2.05).
03/2013; 22(3):259-266. DOI: 10.1089/jwh.2012.3765
Inflammation may influence gestational hyperglycemia, but to date, the data from observational studies is largely limited to results from the third trimester of pregnancy. Our objective was to evaluate first trimester adipocytokine levels. We sought to determine whether first trimester adiponectin and tumor necrosis factor-alpha (TNF)-alpha concentrations were independently associated and predictive of maternal glucose tolerance, as measured by the 1-hour glucose challenge test (GCT), after adjustment for maternal lifestyle behaviors and body mass index (BMI).
Material and methods:
Prospective study of pregnant women (n=211) enrolled in the Parity, Inflammation, and Diabetes Study. Nonfasting serum levels of adiponectin and TNF-r2 were measured at 8-14 weeks of pregnancy. GCT results were abstracted from electronic prenatal records. Multiple linear regression models were developed to determine the association of adiponectin and TNF-r2 levels with response to the GCT, adjusting for demographics, pregravid dietary intake and physical activity, first trimester BMI, and gestational weight gain.
At baseline, higher adiponectin concentrations were inversely and statistically significantly associated with maternal response to the GCT [regression coefficient (β) -0.68; 95% confidence interval (CI): -1.29, -0.06). Adjustment for lifestyle factors did not alter the association of adiponectin with the GCT (β -0.74; 95% CI: -1.43, -0.05). After adjustment for first trimester BMI, the association of adiponectin was attenuated and no longer significant (β -0.46; 95% CI: -1.15, 0.24). TNF-r2 levels were not associated with the GCT (β -0.003; 95% CI: -0.011, 0.005).
First trimester adiponectin levels are not predictive of the 1-hour GCT response, but may be a marker for the effect of maternal BMI on glucose response to the GCT.
Available from: PubMed Central
- "Hedderson et al.  have reported that women in the lowest quartile of adiponectin have a 5-fold increased risk of GDM (OR, 5.2; 95% CI, 2.6 to 10.1) compared to women in the lowest quartile. The association between lower adiponectin and higher glucose levels is also present in the first and early second trimester of pregnancy [66,67] and later in pregnancy , independent of BMI. "
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ABSTRACT: Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
Diabetes & metabolism journal 02/2014; 38(1):1-12. DOI:10.4093/dmj.2014.38.1.1
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ABSTRACT: Approximately 5-10% of subjects with prediabetes become diabetic every year. Inflammation is involved in the development of obesity-related type 2 diabetes (T2D). However, to date, the relationship between inflammation and prediabetes, defined by hemoglobin A1c (HbA1c) ⩾5.7 and <6.5%, remains largely unexplored, especially in African Americans. Therefore, in this study we examined a comprehensive panel of 13 cytokines involved in the inflammatory response in overweight/obese subjects with prediabetes. A total of 21 otherwise healthy, overweight/obese, young adult African American females with prediabetes, together with 20 matched overweight/obese controls, were selected for this study. Plasma cytokines were assessed by multiplex cytokine profiling. Plasma concentrations of interleukin (IL)-5, IL-6, IL-7, tumor necrosis factor-α (TNF-α), and granulocyte-monocyte colony-stimulating factor (GM-CSF) were significantly higher in the prediabetic group, as compared to the control group (all p<0.05). Plasma concentrations of all the other cytokines, interferon-γ (IFN-γ), IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12p70 and IL-13, seemed to be elevated in the prediabetic group, but failed to reach statistical significances. Upon merging both groups, HbA1c was found to be positively correlated with IFN-γ, IL-1β, IL-2, IL-5, IL-7, IL-8, TNF-α and GM-CSF. This study demonstrates elevated levels of various pro-inflammatory cytokines in overweight/obese young subjects with prediabetes, which place them at higher risk of developing T2D and cardiovascular diseases. Our data also call for further investigations in animal models and population cohorts to establish the roles of a variety of pro-inflammatory cytokines in the early development of obesity-related T2D.
Cytokine 06/2013; 64(1). DOI:10.1016/j.cyto.2013.05.025 · 2.66 Impact Factor
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Although the association between inflammation and insulin resistance is well known, the data related to the role of inflammation in gestational diabetes mellitus (GDM) are conflicting. The aim of this study was to investigate the association of several inflammatory mediators with the glycemic status in pregnancy.
Leukocyte count, ferritin, C-reactive protein (CRP), fibrinogen and interleukin-6 levels were measured in 70 patients with normal glucose tolerance, in 57 patients with impaired glucose tolerance and in 35 patients with GDM as determined based on 50-gram oral glucose tolerance test (OGTT) and 100-gram OGTT results.
A significant difference among the groups was seen only with regard to CRP and fibrinogen levels; however, no significant differences were observed after adjustment for body mass index (BMI). CRP was found to be strongly associated with current BMI in all three groups.
Maternal serum levels of inflammatory mediators are not related to GDM at the time of the glucose challenge test in the late second or early third trimester. The significant difference in the levels of CRP in different strata of glycemic tolerance was not observed after adjustment for BMI. Adiposity may have a central role in GDM, causing an inflammatory response.
Gynecologic and Obstetric Investigation 05/2014; 78(1). DOI:10.1159/000362230 · 1.70 Impact Factor
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