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Influence of gestational diabetes mellitus and maternal obesity on insulin resistance and levels on adipokines in mathernal and umbilical blood

The goal of this study is to define the influence of maternal obesity and GDM as separate and associated factors on levels of adipokines in maternal and umbilical vein blood. Research included 160 pregnant women divided into four groups as follows: group of pregnant women without GDM and with BMI<25, group of pregnant women without GDM and with BMI>25, group of pregnant women with GDM and with BMI<25 and group of pregnant women with GDM and with BMI>25. Pregnant women that had any other disease or pathological condition were excluded from study. Maternal and umbilical vein blood samples during delivery were taken and glucose concentration along with insulin, C-peptide, leptin, adiponectin, resistin andTNF-a were measured.Valuesof insulin resistance were calculated using HOMA-IRformula. Within our group of pregnant women without GDM and with BMI <25, mean values in maternal blood were: glucose 5.03±0.75mmol/L, insulin 18.18+ 8.50mU/L, C-peptide, 843.30±379.35pg/l, leptin 29.12±15.77ng/mL, adiponectine 13.92±4.55ug/mL, TNF-a 12.38±4.59 pg/mL, resis¬tin 5.37(min.1.52, max. 12.30), and maternal IR was 4.05±1.99. Values measured from umbilical vein blood were: glucose 2.89±0.60 mmol/L, insulin 3.83 (min. 0.49, max. 11.34), C-peptide, 262.94 +99.48pg/l, leptin 8.09 (min. 2.39, max. 26.66), adiponectine 38.53± 8.00ug/mL, TNF-a 16.24 (min. 7.32, max. 41.36), resistin 8.32±2.32ng/mL and IR was 0.44 (min. 0.07, max. 1.52). Overweight and GDM of a mother correlated with higher concentrations of C-peptide from umbilical blood, but when both conditions were present the influence was even stronger. Maternal GDM is associated with insulin resistance of a child, and overweight only increases the effect on enhance when already GDM is present. Over¬weight is associated with higher concentration of leptin. Overweight and GDM are connected with lower levels of umbilical TNF-a. Maternal overweight and GDM are connected with lower levels of umbilical resistin and there is also combined influence.

gestational diabetes mellitus; obesity; insulin resistance; adipokines; mathernal blood; umbilical blood

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