Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Internal Medicine, National Medical Center, Seoul, Korea.
Endocrinol Metab (Seoul). 2021 Feb;36(1):114-122. doi: 10.3803/EnM.2020.831. Epub 2021 Feb 24.
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.
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.
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.
Serial changes of HMW adiponectin are associated with the maintenance of glucose metabolism in women with pGDM after delivery.
先前患有妊娠期糖尿病（pGDM）的女性，其脂肪因子的连续变化对妊娠至产后期间的母体葡萄糖代谢的影响尚未得到充分探索。我们试图研究 pGDM 女性中脂肪因子的连续变化与糖尿病（DM）发展之间的关系。
我们在怀孕期间以及产后 2 个月和 3 年内连续测量了以下脂肪因子：高分子量（HMW）脂联素、视黄醇结合蛋白-4（RBP-4）、脂钙素-2 和趋化素。根据产后 3 年的血糖状况，我们将其分为三组：正常糖耐量（GDM-NGT，n=20）、糖耐量受损（GDM-IGT，n=23）和 GDM-DM（n=22）。我们分析了脂肪因子与各种代谢参数之间的相关性。
怀孕期间三组妇女的血浆 HMW 脂联素水平没有差异。然而，与 GDM-DM 组相比，GDM-NGT 组妇女在产后 3 年时 HMW 脂联素水平升高。在 GDM-IGT 组中，与妊娠期间相比，HMW 脂联素水平在产后 2 个月时升高。相比之下，在 GDM-DM 组中，HMW 脂联素水平在分娩后没有变化。HMW 脂联素与体重指数和胰岛素抵抗的稳态模型评估呈负相关。其他脂肪因子，如 RBP-4、脂钙素-2 和趋化素，在各组之间没有差异，也与产后 3 年的葡萄糖不耐受状态没有显著相关性。
HMW 脂联素的连续变化与 pGDM 女性产后葡萄糖代谢的维持有关。
