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SERUM ADIPONECTIN DURING PREGNANCY AND POSTPARTUM IN WOMEN WITH GESTATIONAL DIABETES AND NORMAL CONTROLS


N. Vitoratos, A. Deliveliotou, N. F. Vlahos, G. Mastorakos, K. Papadias, D. Botsis, G. K. Creatsas

Aims: To investigate changes in serum adiponectin during pregnancy and postpartum and assess relationship with insulin resistance as measured by the homeostatic model assessment (HOMA-IR).
Methods: Twenty two normal pregnant women were compared to 22 women diagnosed with gestational diabetes (GDM). Serum adiponectin levels were measured at the time of glucose challenge test as well as in the immediate postpartum period and correlation of adiponectin to HOMA-IR were performed.
Results: Adiponectin were significantly lower in pregnant women with GDM as compared to controls (5381 vs 8449 ng/dl, P=0.004) as well as postpartum, (3278 vs 6958 ng/ml, P=0.002).   A significant reduction in adiponectin (3278 vs 5381 ng/ml, P=0.002) was observed postpartum in GDM women but not in controls. Using a lower cut-off value of 5253 ng/ml, maternal adiponectin could exclude GDM with a sensitivity of 86.4% and specificity of 59.1 %, (EUC=0.752, SE=0.77, 95% CI: 0.601-0.903, P=0.004).  Adiponectin levels during pregnancy were negatively correlated to HOMA-IR (r= -.375, P=0.012).
Conclusion: GDM is associated with decreased adiponectin serum levels both in pregnancy as well as postpartum. Adiponectin is negatively correlated to HOMA-IR. A reduction in maternal adiponectin after delivery indicates a significant placental contribution in adiponectin’s production.

Key Words: adiponectin, gestational diabetes, HOMA, insulin resistance

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