The rs266729 single-nucleotide polymorphism in the adiponectin gene shows association with gestational diabetes.

AIM: Gestational diabetes mellitus (GDM) is a condition of impaired glucose tolerance during pregnancy in women without previous diagnosis of diabetes. It is associated with serious complications for both mother and child in the pre- and postnatal period. Moreover, women with GDM are at an increased risk of developing type 2 diabetes. Adiponectin is an important factor involved in the regulation of both carbohydrate and lipid metabolism. Polymorphisms in its gene (ADIPOQ) are known to affect the individual's predisposition to metabolic syndrome and type 2 diabetes. The aim of the current study was to investigate the possible association between three common single-nucleotide polymorphisms in ADIPOQ and gestational diabetes. METHODS: A total of 394 individuals were recruited to the study-130 pregnant women with GDM, 130 pregnant women without glucose intolerance and 134 female population controls. All subjects were genotyped for rs266729, rs2241766 and rs1501299 in the ADIPOQ gene. RESULTS: A significant association with the disease was observed for rs266729 (p = 0.0037). The rare G allele was found to be over-represented among controls (pregnant, population and pooled). While no association was found for rs2241766 and rs1501299, a GTG haplotype formed by the three polymorphisms was found to be more common among controls (0.004). CONCLUSION: The adiponectin promoter polymorphism rs266729 is associated with gestational diabetes. The minor G allele appears to confer protection against pregnancy-related diabetes mellitus. This effect is probably due to the influence of the variant on the adiponectin transcription regulation during gestation.

Comparative analysis of current diagnostic criteria for gestational diabetes mellitus.

BACKGROUND: To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. METHODS: A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. RESULTS: The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% (P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. CONCLUSION: The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.