Endocrinol Metab.  2021 Feb;36(1):114-122. 10.3803/EnM.2020.831.

Longitudinal Changes of High Molecular Weight Adiponectin are Associated with Postpartum Development of Type 2 Diabetes Mellitus in Patients with Gestational Diabetes Mellitus

Affiliations
  • 1Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
  • 2Department of Internal Medicine, National Medical Center, Seoul, Korea
  • 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 4Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Abstract

Background
The influence of serial changes of adipokines on maternal glucose metabolism from pregnancy to postpartum periods in women with previous gestational diabetes mellitus (pGDM) has not been thoroughly explored. We tried to examine the relationship between the serial changes of adipokines and the development of diabetes mellitus (DM) in women with pGDM.
Methods
We longitudinally measured following adipokines: high molecular weight (HMW) adiponectin, retinol-binding protein-4 (RBP-4), lipocalin-2, and chemerin, during pregnancy, and at 2 months and 3 years after delivery. Based on glucose status at postpartum 3 years, we divided into three groups: normal glucose tolerance (GDM-NGT, n=20), impaired glucose tolerance (GDM-IGT, n=23), and GDM-DM (n=22). We analyzed the correlations between adipokines and various metabolic parameters.
Results
Plasma HMW adiponectin levels were not different among the three groups during pregnancy. However, HMW adiponectin levels increased at 3 years after the delivery in women with GDM-NGT compared with women with GDM-DM. In the GDM-IGT group, HMW adiponectin levels increased at 2 months postpartum compared to pregnancy period. In contrast, HMW adiponectin levels showed no alternation after parturition in women with GDM-DM. HMW adiponectin was negatively correlated with body mass index and a homeostasis model assessment of insulin resistance. Other adipokines such as RBP-4, lipocalin-2, and chemerin neither showed any differences among the groups nor any significant correlations with 3 years postpartum status of glucose intolerance.
Conclusion
Serial changes of HMW adiponectin are associated with the maintenance of glucose metabolism in women with pGDM after delivery.

Keyword

Diabetes, gestational; Diabetes mellitus, type 2; Adipokines; Adiponectin

Figure

  • Fig. 1 Serial change of plasma high molecular weight (HMW) adiponectin concentrations during pregnancy, 2 months, and 3 years after delivery. (A) In gestational diabetes mellitus (GDM)-normal glucose tolerance (NGT) group, HMW adiponectin concentrations significantly increased at 3 years postpartum compared with during pregnancy and at 2 months postpartum. (B) In GDM-impaired glucose tolerance (IGT) group, HMW adiponectin concentrations significantly increased at 2 months and 3 years postpartum compared with during pregnancy. (C) In GDM-diabetes mellitus (DM) group, no significant changes in HMW adiponectin concentration were observed. aP<0.05 vs. during pregnancy; bP<0.05 vs. postpartum 2 months.


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