Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus

Monique M. Hedderson, Jeanne Darbinian, Peter J Havel, Charles P. Quesenberry, Sneha Sridhar, Samantha Ehrlich, Assiamira Ferrara

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective-To examine whether circulating total and high-molecular weight (HMW) adiponectin concentrations, measured before pregnancy, are associated with subsequent risk of gestational diabetes mellitus (GDM). Research design and methods-This was a nested case-control study among women who participated in the Kaiser Permanente Northern California Multiphasic Health Check-up exam (1984-1996) with a serum sample obtained and who had a subsequent pregnancy (1984-2009). Eligible womenwere free of recognized diabetes. Case subjects were the 256 women who developed GDM. Two control subjects were selected for each case and matched for year of blood draw, age at exam, age at pregnancy, and number of intervening pregnancies. Results-Compared with the highest quartile of adiponectin, the risk of GDM increased with decreasing quartile (odds ratio [OR] 1.5 [95% CI 0.7-2.9], 3.7 [1.9-7.2], and 5.2 [2.6- 10.1]; Ptrend <0.001) after adjustment for family history of diabetes, BMI, parity, race/ethnicity, cigarette smoking, and glucose and insulin concentrations. Similar estimates were observed for HMW(Ptrend <0.001). The combined effects of having total adiponectin levels below the median (<10.29 mg/mL) and being overweight or obese (BMI ≥25.0 kg/m2) were associated with a sevenfold increased risk of GDM compared with normal-weight women with adiponectin levels above the median (OR 6.7 [95% CI 3.6-12.5]). Conclusions-Prepregnancy low adiponectin concentrations, a marker of decreased insulin sensitivity and altered adipocyte endocrine function, is associated with reduced glucose tolerance during pregnancy and may identify women at high risk for GDM to target for early intervention.

Original languageEnglish (US)
Pages (from-to)3930-3937
Number of pages8
JournalDiabetes Care
Volume36
Issue number12
DOIs
StatePublished - Dec 2013

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Gestational Diabetes
Adiponectin
Pregnancy
Molecular Weight
Odds Ratio
Glucose
Parity
Adipocytes
Insulin Resistance
Case-Control Studies
Research Design
Smoking
Insulin
Weights and Measures
Health
Serum

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus. / Hedderson, Monique M.; Darbinian, Jeanne; Havel, Peter J; Quesenberry, Charles P.; Sridhar, Sneha; Ehrlich, Samantha; Ferrara, Assiamira.

In: Diabetes Care, Vol. 36, No. 12, 12.2013, p. 3930-3937.

Research output: Contribution to journalArticle

Hedderson, Monique M. ; Darbinian, Jeanne ; Havel, Peter J ; Quesenberry, Charles P. ; Sridhar, Sneha ; Ehrlich, Samantha ; Ferrara, Assiamira. / Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus. In: Diabetes Care. 2013 ; Vol. 36, No. 12. pp. 3930-3937.
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abstract = "Objective-To examine whether circulating total and high-molecular weight (HMW) adiponectin concentrations, measured before pregnancy, are associated with subsequent risk of gestational diabetes mellitus (GDM). Research design and methods-This was a nested case-control study among women who participated in the Kaiser Permanente Northern California Multiphasic Health Check-up exam (1984-1996) with a serum sample obtained and who had a subsequent pregnancy (1984-2009). Eligible womenwere free of recognized diabetes. Case subjects were the 256 women who developed GDM. Two control subjects were selected for each case and matched for year of blood draw, age at exam, age at pregnancy, and number of intervening pregnancies. Results-Compared with the highest quartile of adiponectin, the risk of GDM increased with decreasing quartile (odds ratio [OR] 1.5 [95{\%} CI 0.7-2.9], 3.7 [1.9-7.2], and 5.2 [2.6- 10.1]; Ptrend <0.001) after adjustment for family history of diabetes, BMI, parity, race/ethnicity, cigarette smoking, and glucose and insulin concentrations. Similar estimates were observed for HMW(Ptrend <0.001). The combined effects of having total adiponectin levels below the median (<10.29 mg/mL) and being overweight or obese (BMI ≥25.0 kg/m2) were associated with a sevenfold increased risk of GDM compared with normal-weight women with adiponectin levels above the median (OR 6.7 [95{\%} CI 3.6-12.5]). Conclusions-Prepregnancy low adiponectin concentrations, a marker of decreased insulin sensitivity and altered adipocyte endocrine function, is associated with reduced glucose tolerance during pregnancy and may identify women at high risk for GDM to target for early intervention.",
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