Endocrine Abstracts

Introduction: Pregnancy is characterized by a progressive insulin resistance (IR). Some, but not all, previously published studies suggest that adipokines are related to insulin resistance in pregnant women and subsequent development of gestational diabetes (GDM).

The aim of this study was to investigate the relation between adiponectin, leptin, its ratio and homeostasis model assessment of IR (HOMA-IR) in the first prenatal visit and whether it could be used to predict the risk of developing GDM.

Methods: One hundred and forty-three women were recruited before 15 weeks of gestation and were followed up until delivery. Maternal plasma adiponectin, leptin concentrations were measured and IR was assessed by HOMA-IR at 8–14 weeks of gestation. 2 h 75 g oral glucose tolerance test (OGTT) was performed between 24 and 28 weeks of gestation. GDM was diagnosed according to IADPSG criteria.

Results: The 124 healthy and the 19 women who subsequently developed GDM had similar levels of adiponectin (P=0.153), leptin (P=0.103) and HOMA-IR (P=0.115).). However the adiponectin/leptin (A/L) ratio was significantly higher in healthy pregnant women than in those who developed GDM (1.01 vs 0.68, P=0.034). We found a significant negative correlation between A/L ratio and HOMA-IR (r=−0.43; P<0.001), adiponectin concentration and HOMA-IR (r=−0.229; P=0.013), adiponectin and leptin (r=−0.286; P=0.001), A/L ratio and BMI before pregnancy (r=−0.666; P<0.001) and a positive correlation between leptin and HOMA-IR (r=−0.43; P< 0.001).

Conclusion: A/L ratio negatively correlates with HOMA-IR in early pregnancy and has a potential of biomarker for the prediction of GDM.