Endocrine Abstracts

Introduction: CTRP-1 belongs to the adipose tissue-derived C1qTNF superfamily of proteins involved in e.g. glucose metabolism regulation. Recent studies have shown significant differences in CTRP-1 levels between type 2 diabetics and controls. We aim at investigating a possible link between gestational diabetes mellitus (GDM) and CTRP-1 as there is little data on CTRP-1 and its possible functions in pregnancy.

Patients and Methods: In 167 women (93 with normal glucose tolerance (NGT), 74 GDM) of a high-risk population for GDM at a tertiary treatment center, CTRP-1 levels were investigated in respect to GDM. Glucose tolerance, insulin resistance and secretion were assessed with indices (Matsuda index, Stumvoll first phase index, ISSI- 2, AUC insulin, AUC glucose) derived from an oral glucose tolerance test (oGTT) performed at <21 weeks of gestation (GW) and GW 24 to 28. GDM (44.3% of whole cohort) was further divided into GDM subtypes depending on a predominant insulin sensitivity (GDM-IR) or secretion deficit (GDM-IS).

Results: There was no significant difference in CTRP-1 levels between GDM (mea n = 76.86 ng/ml; s.d. = 37.81) compared to NGT (P = 0.104). However, GDM-IR women (44.00 ± 43.00 ng/ml) had significantly lower CTRP-1 levels compared to the GDM-IS group (83.79 ± 23.08 ng/ml; P < 0.001) and women with NGT (82.2 ± 35.34 ng/ml; P < 0.001) Throughout pregnancy, CTRP-1 levels did not change significantly, except for the GDM-IR group. Here, CTRP-1displayed a downwards trend when correlated with gestation week. In the whole population, CTRP-1 levels correlated negatively with BMI, diastolic blood pressure, AUC insulin, adiponectin levels, fetal birth weight and positively with HbA1c, Matsuda Index and ISSI-2.

Conclusion: The results of the present study further point towards CTRP-1 being a metabolic biomarker for insulin resistance in GDM. To establish its exact function, further investigations on CTRP-1 in relation to hyperglycemia and insulin resistance are imperative.