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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Maternal serum adiponectin multimers in gestational diabetes

Shali Mazaki-Tovi1, 2 / Roberto Romero1, 3 / Edi Vaisbuch1, 2 / Offer Erez1, 2 / Pooja Mittal1, 2 / Tinnakorn Chaiworapongsa1, 2 / Sun Kwon Kim1 / Percy Pacora1 / Lami Yeo1, 2 / Francesca Gotsch1 / Zhong Dong1 / Bo Hyun Yoon4 / Sonia S. Hassan1, 2 / Juan Pedro Kusanovic1, 2

1Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, Detroit, MI, USA

2Department of Obstetrics and Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, USA

3Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI and Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA

4Department of Obstetrics and Gynecology, Seoul National University, Seoul, Korea

Corresponding author: Roberto Romero, MD Perinatology Research Branch Intramural Division, NICHD/NIH/DHHS Hutzel Women's Hospital-Box No. 4 3990 John R Detroit, MI 48201 USA Tel.: +1-(313) 993-2700 Fax: +1-(313) 993-2694

Citation Information: Journal of Perinatal Medicine. Volume 37, Issue 6, Pages 637–650, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2009.101, June 2009

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Objective: Adiponectin, an adipokine with profound insulin-sensitizing effect, consists of heterogeneous species of multimers. These oligomeric complexes circulate as low-molecular-weight (LMW) trimers, medium-molecular-weight (MMW) hexamers and high-molecular-weight (HMW) isoforms and can exert differential biological effects. The aims of this study were to determine whether there is a change in circulating adiponectin multimers in the presence of gestational diabetes mellitus (GDM), overweight/obesity or with a treatment with sulfonylurea or insulin in patients with GDM.

Study design: This cross-sectional study included women with: 1) normal pregnancy (n=149); and 2) patients with GDM (n=72). Thirty-three patients with GDM were managed with diet alone. Among the others 39 diabetic patients, 17 were treated with Glyburide and 22 with insulin. The study population was further stratified by first trimester body mass index (BMI) (normal weight <25 kg/m2 vs. overweight/obese ≥25 kg/m2). Serum adiponectin multimers (total, HMW, MMW and LMW) concentrations were determined by ELISA.

Results: 1) The median maternal serum of total, HMW, MMW and LMW were lower in patients with GDM than in those with normal pregnancies (P<0.001 for all comparisons); 2) patients with GDM had a lower HMW/total adiponectin ratio and a higher MMW/total and LMW/total adiponectin ratio than those with a normal pregnancy (P<0.001 for all comparisons); and 3) among GDM patients, there were no differences in the concentrations and relative distribution of adiponectin multimers between those who were managed with diet, and those who were treated with pharmacological agents.

Conclusion: 1) GDM is characterized by a distinctive pattern of concentrations and relative distribution of adiponectin multimers akin to Type 2 diabetes mellitus; 2) dysregulation of adiponectin multimeres can provide a mechanistic basis for the association between adiposity and GDM.

Keywords: Adipokines; body mass index (BMI); diabetes; gestational diabetes; high-molecular-weight (HMW) adiponectin; low-molecular-weight (LMW) adiponectin; medium-molecular-weight (MMW) adiponectin; obesity; overweight; pregnancy

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