Reduced Adiponectin Concentration in Women With Gestational Diabetes

Adiponectin, a novel protein secreted exclusively by adipocytes, has emerged as an important potential mediator of the insulin resistance that is so characteristic of obesity, type 2 diabetes, and atherosclerotic cardiovascular disease (1,2). Consistent with the established inverse relationship between plasma adiponectin concentration and insulin resistance, hypoadiponectinemia has been documented in patients with each of these pathologic conditions (3–7). Moreover, in the Pima Indian population, low baseline adiponectin concentration predicts the subsequent development of insulin resistance (8), whereas conversely, elevated baseline adiponectin levels have been shown to be protective against the future development of type 2 diabetes (9). Taken together, these observations suggest that hypoadiponectinemia may be an important factor in the development of insulin resistance and the pathophysiology of type 2 diabetes. Gestational diabetes mellitus (GDM) identifies a population of young women at high risk of developing type 2 diabetes (10), representing an early stage in the natural history of the disease. Thus, we hypothesized that hypoadiponectinemia may be associated with GDM. The present study investigated the relationship between adiponectin and glucose tolerance in pregnancy. The study design, protocol, and laboratory methods have been fully described previously (11). The study protocol was approved by the research ethics board at Mount Sinai Hospital, and all subjects gave written informed …