Abstract
Plasma concentrations of adiponectin, tumor necrosis factor-α (TNF-α) and its soluble
receptors sTNFR-1 and sTNFR-2 were measured in 80 patients with gestational diabetes
(GDM) (mean age 29.0 ± 4.9 years) and 30 pregnant women with normal glucose tolerance
(NGT) (mean age 28.2 ± 6.0 years). We found that GDM patients had significantly lower
concentrations of adiponectin (11.28 ± 5.91 vs. 16.31 ± 6.04 μg/ml, p = 0.00009) and elevated levels of TNF-α (1.71 ± 0.92 vs. 1.27 ± 0.42 pg/ml, p = 0.0175) in comparison to NGT women. The differences remained
statistically significant after adjusting for BMI. Plasma levels of sTNFR-1 and sTNFR-2
also tended to be higher in GDM patients. In the GDM group TNF-α concentrations correlated
significantly with sTNFR-1 (r = 0.444, p = 0.00008), sTNFR-2 (r = 0.364, p = 0.0016)
and with C-peptide concentrations (r = 0.318, p = 0.016), whereas in women with NGT
TNF-α correlated only with TG levels (r = 0.50, p = 0.024). Multivariate linear regression
analysis revealed that prepregnant BMI was the most predictive indicator of TNF-α
concentrations in GDM women. TG concentrations as well as BMI before pregnancy and
at the time of sampling in pregnant NGT women were significant predictors, explaining
62 % of the variance in TNF-α concentration. There were also negative correlations
between adiponectin concentrations and a pregestational BMI (r = - 0.298, p = 0.009),
BMI at the time of sampling (r = - 0.239, p = 0.034) and TG concentrations (r = -
0.379, p = 0.039) in GDM patients, whereas women with NGT showed only a negative correlation
between adiponectin and TG concentrations (r = - 0.488, p = 0.025). In a multivariate
regression analysis, prepregnancy BMI and TG levels remained significant predictors,
explaining 39 % of the variation in plasma adiponectin concentration in GDM women.
In conclusion, our results suggest that decreased adiponectin concentration in GDM
may not simply reflect maternal adiposity and insulin resistant state, but may contribute
to the impaired glucose metabolism during pregnancy, with potential implications for
screening and prevention of the disease.
Key words
Gestational diabetes mellitus - Tumor necrosis factor-α - sTNFR-1 - sTNFR-2 - Adiponectin
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2015-2020
M. Kinalski
Department of Pathophysiology of Pregnancy, Medical University of Białystok
ul. M. Curie-Skłodowska 24A · 15-276 Białystok · Poland
Telefon: +48(85)7468352
Fax: +48(85)7468682 ·
eMail: Telejkob@poczta.onet.pl
