Plasma Adiponectin, Insulin Sensitivity, and Subclinical Inflammation in Women With Prior Gestational Diabetes Mellitus
Article Figures & Tables
Tables
- Table 1—
Clinical characteristics, metabolic parameters, and fasting plasma concentrations of adipocytokines and CRP of pGDM, pGDM-R, and pGDM-S compared with NGT 3 months after delivery
pGDM pGDM-R pGDM-S NGT n 89 30 59 19 Age (years) 32.2 ± 0.5 32.0 ± 1.0 32.4 ± 0.6 31.9 ± 1.3 BMI (kg/m2) 26.9 ± 0.5* 29.1 ± 1.1 24.8 ± 0.5 23.7 ± 0.9† BFM (kg) 26.0 ± 1.1* 31.5 ± 2.1 21.6 ± 1.1 18.7 ± 1.4† Waist circumference (cm) 90.6 ± 1.3* 94.6 ± 2.3‡ 88.2 ± 1.7 76.3 ± 1.7†§ Triglycerides (mg/dl) 104.9 ± 7.0* 110.9 ± 11.0 99.7 ± 9.7 71.8 ± 7.3† HDL cholesterol (mg/dl) 55.3 ± 1.5* 54.6 ± 2.8 56.0 ± 1.7 63.6 ± 3.2†§ HbA1c (%) 5.60 ± 0.06* 5.65 ± 0.10 5.54 ± 0.07 5.17 ± 0.04†§ Fasting glucose (mg/dl) 90.7 ± 1.3* 93.2 ± 2.1‡ 88.3 ± 1.5 82.8 ± 1.2†§ 2-h glucose (mg/dl)OGTT 121.1 ± 3.7* 130.3 ± 7.0‡ 115.1 ± 4.5 90.6 ± 3.5†§ OGIS (ml · min−1 · m−2)OGTT 439.5 ± 9.9* 391.7 ± 15.8‡ 469.0 ± 11.6 504.2 ± 13.7† Si [10−4 min−1 (μU/ml)−1]FSIGT 3.95 ± 0.29* 1.63 ± 0.10‡ 5.22 ± 0.33 6.0 ± 0.6† Disposition index (10−2 · min−1)FSIGT 0.119 ± 0.01* 0.064 ± 0.01‡ 0.148 ± 0.01 0.170 ± 0.02† Adiponectin (μg/ml) 6.70 ± 0.23* 6.52 ± 0.40 6.93 ± 0.29§ 9.80 ± 0.60† Insulin (pmol/l) 61.2 ± 4.2 83.4 ± 9.0‡ 41.5 ± 1.8 50.4 ± 3.6† Leptin (ng/ml) 14.9 ± 0.8* 18.5 ± 1.3‡ 13.3 ± 0.9§ 9.2 ± 1.4† PAI-1 (ng/ml) 28.7 ± 2.1* 34.3 ± 3.6‡ 24.5 ± 2.5§ 15.6 ± 1.7† TNF-α (pg/ml) 5.2 ± 0.7 4.5 ± 1.2 5.6 ± 1.0 3.3 ± 0.4 IL-6 (pg/ml) 2.0 ± 0.3* 2.2 ± 0.6 1.8 ± 0.3 1.4 ± 0.6 CRP (mg/dl) 0.45 ± 0.06* 0.54 ± 0.11 0.38 ± 0.09 0.18 ± 0.04† - Table 2—
Mean values of metabolic parameters and fasting plasma concentrations of adipocytokines after adjustment for waist circumference or BFM of pGDM, pGDM-R, and pGDM-S compared with NGT 3 months after delivery
pGDM pGDM-R pGDM-S NGT n 89 30 59 19 HbA1c (%) Adjusted for WC 5.54 5.48 5.53 5.24 Adjusted for BFM 5.57* 5.51 5.54 5.21 Fasting glucose (mg/dl) Adjusted for WC 89.00 88.51 87.85 82.33 Adjusted for BFM 89.93* 87.97 89.27 81.36 2-h glucose (mg/dl)OGTT Adjusted for WC 117.98* 121.01 114.40 90.85 Adjusted for BFM 119.82† 122.43 117.82‡ 89.87# Si [10−4 · min−1 (μU/ml)−1]FSIGT Adjusted for WC 4.18 1.79‖ 5.29 4.16# Adjusted for BFM 4.03* 1.75¶ 4.77 5.34§ Adiponectin (μg/ml) Adjusted for WC 6.92* 6.85 6.95‡ 9.25# Adjusted for BFM 6.71* 6.21 6.76‡ 9.60# PAI-1 (ng/ml) Adjusted for WC 26.73 30.94 23.66 17.40 Adjusted for BFM 27.52* 31.03 39.41 18.14 Leptin (ng/ml) Adjusted for WC 14.08 15.97 13.42 15.42 Adjusted for BFM 14.26 15.24 14.43 13.52 - Table 3—
Correlations of adiponectin plasma concentrations with parameters of glucose and lipid metabolism, adipocytokines, and inflammatory proteins (Spearman correlation coefficient) in all women as well as partial correlation analysis after adjustment of the effect of BFM, waist-to-hip ratio, or Si
Adiponectin Adjusted for BFM Adjusted for waist-to-hip ratio Adjusted for Si r P r P r P r P Si 0.40 <0.0001 0.26 <0.009 0.20 0.04 — — Disposition indexFSIGT 0.33 0.0008 0.23 <0.02 0.22 0.03 — — Basal insulin secretionOGTT −0.31 0.001 −0.19 <0.05 −0.14 0.16 −0.15 0.14 Fasting glucose −0.42 <0.0001 −0.26 <0.009 −0.20 0.04 −0.24 <0.02 Postload glucose2-h OGTT −0.44 <0.0001 −0.36 <0.0003 −0.26 0.008 −0.30 <0.003 Triglycerides −0.30 0.002 −0.22 <0.02 −0.13 0.19 −0.23 <0.03 HDL cholesterol 0.48 <0.0001 0.44 <0.0001 0.38 0.0001 0.41 <0.0001 PAI-1 −0.51 <0.0001 −0.44 <0.0001 −0.31 0.001 −0.38 <0.0001 pGDM plus healthy control subjects, n = 108.
- Table 4—
Stepwise linear regression of independent variables associated with adiponectin concentrations
Independent variables Parameter estimate SE P Intercept 4.31 1.62 0.009 HDL cholesterol 0.073 0.019 0.0004 Postload glucose2-h OGTT −0.018 0.007 0.02 Si 0.204 0.099 0.04 Independent variables: fasting and postload glucose2-hOGTT, triglycerides, HDL cholesterol, PAI-1, Si, disposition indexFSIGT, basal insulin secretionOGTT, and waist circumference; 0.15 significance level for entry of variables into the model. Dependent variable = fasting plasma adiponectin concentration. FSIGT, frequently sampled intravenous glucose tolerance test.
- Table 5—
12-month follow-up after delivery of pGDM and the respective pGDM-R and pGDM-S subgroups
pGDM pGDM-R pGDM-S n 44 16 28 Body fat content (kg) 26.1 ± 1.8 32.9 ± 3.0 21.8 ± 1.8 Waist circumference (cm) 88.5 ± 1.9 95.0 ± 2.8 84.9 ± 2.4 Triglycerides (mg/dl) 123.1 ± 11.1* 111.2 ± 14.8 127.8 ± 16.5 HDL cholesterol (mg/dl) 49.7 ± 1.9† 47.7 ± 2.5 51.1 ± 2.8 HbA1c (%) 5.5 ± 0.1† 5.6 ± 0.3 5.3 ± 0.1 Fasting glucose (mg/dl) 95.7 ± 3.5 99.3 ± 8.2 112.9 ± 6.0 OGIS (ml · min−1 · m−2)OGTT 426.4 ± 28.2 398.8 ± 34.8 454.3 ± 17.8 Plasma adiponectin (μg/ml) 6.64 ± 0.4 6.08 ± 0.6* 6.83 ± 0.56
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