This Article Full Text Full Text (PDF) All Versions of this Article: 93/8/3142    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Google Scholar Articles by Choi, S. H. Articles by Jang, H. C. PubMed PubMed Citation Articles by Choi, S. H. Articles by Jang, H. C. Related Collections Diabetes and Insulin Female Endocrinology Metabolism

High Plasma Retinol Binding Protein-4 and Low Plasma Adiponectin Concentrations Are Associated with Severity of Glucose Intolerance in Women with Previous Gestational Diabetes Mellitus

Division of Endocrinology and Metabolism (S.H.C., S.L., Y.J.P., H.C.J.), Department of Internal Medicine, Seoul National University Bundang Hospital, Sungnam City, Gyeonggi-Do 463-707, South Korea; Seoul National University College of Medicine (S.H.C., Y.M.C., H.K.L., Y.J.P., H.C.J., K.S.P.), Seoul 110-799, Korea; Genome Research Center for Diabetes and Endocrine Disease (S.H.K., Y.M.C., H.K.L., K.S.P.), Clinical Research Institute, Seoul National University Hospital, Seoul 110-799, Korea; AdipoGen, Inc. (B.-S.Y., H.L., N.L.), College of Life Science and Biotechnology, Korea University, Seoul 130-701, Korea; Immunomodulation Research Center (B.-S.Y.), University of Ulsan, Ulsan 680-749, Korea; and Division of Endocrinology, Diabetes, and Metabolism (Y.-B.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215

Address all correspondence and requests for reprints to: Hak C. Jang, M.D., Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-Dong, Bundang-Ku, Sungnam City, Gyeonggi-Do 463-707, South Korea. E-mail: janghak{at}snu.ac.kr.

Context: Women with previous gestational diabetes mellitus (pGDM) are at high risk of developing type 2 diabetes mellitus in the future. The role of adipokines in women with pGDM has not been established.

Objective: We investigated whether circulating adipokine concentration is associated with abnormal glucose homeostasis in women with pGDM.

Design, Setting, Patients, and Main Outcome Measures: We measured the plasma concentrations of retinol-binding protein-4 (RBP4), transthyretin (TTR), and adiponectin and metabolic parameters in four groups of women who exhibited normal glucose tolerance (NGT) during a previous pregnancy (NP, n = 17), NGT after GDM (GDM-NGT, n = 72), impaired glucose tolerance after GDM (GDM-IGT, n = 60), and type 2 diabetes after GDM (GDM-DM, n = 8).

Results: Plasma RBP4 concentration was significantly higher in women with GDM-DM, GDM-IGT, and GDM-NGT than in those with NP. RBP4 concentration correlated positively with TTR concentration; fasting plasma glucose, insulin, and triglyceride concentrations; blood pressure; abdominal fat area; and homeostasis model assessment of insulin resistance. Plasma TTR concentration was elevated in women with GDM-DM compared with other groups. In contrast, adiponectin concentration was lowest in the GDM-DM group and correlated inversely with parameters of insulin resistance. Resistin concentration was higher only in the GDM-NGT and GDM-IGT groups, whereas leptin did not differ between groups. Plasma RBP4 and adiponectin concentrations were inversely correlated.

Conclusions: The severity of glucose intolerance in women with pGDM is associated with high RBP4 and low adiponectin concentrations.