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Adipokine Profile and C-Reactive Protein in Pregnancy: Effects of Glucose Challenge Response Versus Body Mass Index

Department of Obstetrics and Gynecology, Katholieke Universiteit Leuven, Leuven, Belgium johan.verhaeghe{at}uz.kuleuven.ac.be

Rita van Bree, MLT

Suzan Lambin, MAgrSc

Silvia Caluwaerts, PhD

Department of Obstetrics and Gynecology, Katholieke Universiteit Leuven, Leuven, Belgium

Objective: To test the hypothesis that gravidas who have an abnormal response to glucose loading have dysfunctional adipose tissue cells that produce more insulin resistance-inducing and proinflammatory adipokines but less insulin-sensitizing adipokines.

Methods: We performed a nested case-control study within a larger sample of gravidas who had a glucose challenge test (GCT) at 24-29 weeks; we compared 73 cases with an abnormal GCT (>8.3 mM) and 146 controls with a strictly normal GCT (<7.2 mM) matched for body mass index (BMI) and height (mean diference between cases and controls: 0. 1 kg/mn² and 1 cm, respectively). We measured plasma insulin, adipokines (leptin, adiponectin, resistin, tumor necrosis factor [TNF]-, interleukin [IL]-6), soluble leptin receptor (sOb-R), the main leptin-binding protein, and C-reactive protein (CRP).

Results: The cases showed a 48% increase in insulin concentrations and a 27% increase in TNF- concentrations compared to the controls (both P < .0001), but leptin, sOb-R, IL-6, and adiponectin, as well as CRP, concentrations were comparable between cases and controls. In the whole group (n = 219), BMI was correlated with insulin, leptin, IL-6, and CRP, and inversely with sOb-R and adiponectin concentrations (all P < .0003).

Conclusions: Plasma leptin, sOb-R, IL-6, and adiponectin, as well as CRP, are strongly related to BMI ingravidas at 24-29 weeks gestational age but not to the glucose loading response. However, TNF- is higher in women with an abnormal GCT. Further studies should disclose the source of increased TNF- in these women, and to assess whether TNF- is causally related to glucose intolerance during pregnancy.

Key Words: Adipokines • C-reactive protein • glucose challenge test • soluble leptin receptor • tumor necrosis factor-

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