Abstract
Background:
Gestational diabetes mellitus (GDM) is increasing partly due to the obesity epidemic. Adipocytokines have thus been suggested as first trimester screening markers for GDM. In this study we explore the associations between body mass index (BMI) and serum concentrations of adiponectin, leptin, and the adiponectin/leptin ratio. Furthermore, we investigate whether these markers can improve the ability to screen for GDM in the first trimester.
Methods:
A cohort study in which serum adiponectin and leptin were measured between gestational weeks 6+0 and 14+0 in 2590 pregnant women, categorized into normal weight, moderately obese, or severely obese.
Results:
Lower concentrations of adiponectin were associated with GDM in all BMI groups; the association was more pronounced in BMI<35 kg/m2 (p=0.30 for interaction). Leptin was inversely associated with GDM in severely obese (p=0.033), but showed no association in women with BMI<35 kg/m2. The adiponectin/leptin ratio was associated with GDM in women with BMI<35 kg/m2 but not in severely obese women (p=0.79). In regard to predicting GDM, maternal characteristics combined with adiponectin alone, adiponcetin and leptin, and adiponcetin/leptin ratio had the strongest associations in women with BMI<35 kg/m2. These models had a detection rate of 77.3%–80.3% when the false positive rate was fixed at 25%.
Conclusions:
Low adiponectin measured in the first trimester is associated with the development of GDM; higher BMI was associated with lower performance of adiponectin, though this was insignificant. Leptin had an inverse relationship with GDM in severely obese women and did not improve the ability to predict GDM.
Acknowledgments
We thank Pia Øllegaard Lind for her coordination and contribution in the laboratory.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This work was supported by a grant from The Region Zealand Health Sciences Research Foundation, grant number: 15–000342 and Holbæk Hospital. This research has been conducted using the Danish National Biobank resource, supported by the Novo Nordisk Foundation.
Employment of leadership: None declared
Honorarium: None declared
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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