Adipokines in early and mid-pregnancy and subsequent risk of gestational diabetes: A longitudinal study in a multiracial cohort

Ellen C. Francis, Mengying Li, Stefanie N. Hinkle, Yaqi Cao, Jinbo Chen, Jing Wu, Yeyi Zhu, Hiaming Cao, Karen Kemper, Lior Rennert, Joel Williams, Michael Y. Tsai, Liwei Chen, Cuilin Zhang

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Abstract

Introduction Several adipokines are implicated in the pathophysiology of gestational diabetes mellitus (GDM), however, longitudinal data in early pregnancy on many adipokines are lacking. We prospectively investigated the association of a panel of adipokines in early and mid-pregnancy with GDM risk. Research design and methods Within the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons cohort (n=2802), a panel of 10 adipokines (plasma fatty acid binding protein-4 (FABP4), chemerin, interleukin-6 (IL-6), leptin, soluble leptin receptor (sOB-R), adiponectin, omentin-1, vaspin, and retinol binding protein-4) were measured at gestational weeks (GWs) 10-14, 15-26, 23-31, and 33-39 among 107 GDM cases (ascertained on average at GW 27) and 214 non-GDM controls. Conditional logistic regression was used to estimate ORs of each adipokine and GDM, controlling for known GDM risk factors including pre-pregnancy body mass index. Results Throughout pregnancy changes in chemerin, sOB-R, adiponectin, and high-molecular-weight adiponectin (HMW-adiponectin) concentrations from 10-14 to 15-26 GWs were significantly different among GDM cases compared with non-GDM controls. In early and mid-pregnancy, FABP4, chemerin, IL-6 and leptin were positively associated with increased GDM risk. For instance, at 10-14 GWs, the OR comparing the highest versus lowest quartile (ORQ4-Q1) of FABP4 was 3.79 (95% CI 1.63 to 8.85). In contrast, in both early and mid-pregnancy adiponectin (eg, ORQ4-Q1 0.14 (0.05, 0.34) during 10-14 GWs) and sOB-R (ORQ4-Q1 0.23 (0.11, 0.50) during 10-14 GWs) were inversely related to GDM risk. At 10-14 GWs a model that included conventional GDM risk factors and FABP4, chemerin, sOB-R, and HMW-adiponectin improved the estimated prediction (area under the curve) from 0.71 (95% CI 0.66 to 0.77) to 0.77 (95% CI 0.72 to 0.82). Conclusions A panel of understudied adipokines including FABP4, chemerin, and sOB-R may be implicated in the pathogenesis of GDM with significant associations detected approximately 10-18 weeks before typical GDM screening.

Original languageEnglish (US)
Article numbere001333
JournalBMJ Open Diabetes Research and Care
Volume8
Issue number1
DOIs
StatePublished - Aug 2 2020

Bibliographical note

Funding Information:
This research was supported by theEunice Kennedy ShriverNational Institute of Child Health and Human Development intramural funding and included American Recovery and Reinvestment Act funding via contract numbers HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, HHSN275201000009C, and HHSN275201000001Z. YZ was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (grant number K01DK120807). ECF is a participant in the NIH Graduate Partnership Program and a graduate student at Clemson University.

Funding Information:
Funding This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding and included American Recovery and Reinvestment Act funding via contract numbers HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, HHSN275201000009C, and HHSN275201000001Z. YZ was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (grant number K01DK120807). ECF is a participant in the NIH Graduate Partnership Program and a graduate student at Clemson University.

Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • adipokines
  • cohort
  • gestational diabetes mellitus
  • prospective

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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