Circulating levels of the adipokine chemerin in gestational diabetes mellitus.

BACKGROUND: Chemerin was recently introduced as a novel adipokine playing a crucial role in adipocyte differentiation and insulin signaling. In the current study, we investigated circulating chemerin levels in patients with gestational diabetes mellitus (GDM) as compared to healthy pregnant controls matched for gestational age and fasting insulin. METHODS: Chemerin was quantified by ELISA in control (n = 80) and GDM (n = 40) patients and correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation, in both groups. RESULTS: Median maternal serum chemerin concentrations were not significantly different in subjects with GDM (230.3 microg/l) as compared to healthy pregnant controls (217.6 microg/l). Chemerin significantly and positively correlated with homeostasis model assessment of insulin resistance (HOMA-IR) and serum creatinine in uni- and multivariate analyses. Furthermore, chemerin serum levels were highest in patients in the third tertile of HOMA-IR. CONCLUSIONS: Chemerin is independently associated with markers of insulin resistance and renal dysfunction but is not dysregulated in GDM if patients are matched with controls for fasting insulin.

Preliminary report: circulating levels of the adipokine vaspin in gestational diabetes mellitus and preeclampsia.

The objective of the study was to investigate serum levels of the insulin-sensitizing adipokine vaspin in patients with gestational diabetes mellitus (GDM) and preeclampsia (PE) as compared with healthy controls of similar gestational age. Vaspin serum levels were quantified by enzyme-linked immunosorbent assay in control (n = 102), GDM (n = 40), and PE (n = 22) subjects. Median maternal vaspin concentrations were not significantly different in GDM, PE, and control subjects. Furthermore, vaspin did not significantly correlate to clinical and biochemical measures of renal function, glucose, and lipid metabolism, as well as inflammation. Circulating vaspin levels are not significantly different between GDM, PE, and control subjects and do not correlate with insulin sensitivity in pregnant subjects.

Serum fibroblast growth factor 21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia.

Fibroblast growth factor 21 (FGF21) has beneficial effects on glucose homeostasis and insulin sensitivity. In the current study, we investigated serum concentrations of FGF21 in patients with gestational diabetes mellitus (GDM) as compared with healthy pregnant controls matched for gestational age and fasting insulin. Fibroblast growth factor 21 was determined by enzyme-linked immunosorbent assay in control (n = 80) and GDM (n = 40) patients and correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation in both groups. Median maternal serum FGF21 concentrations were not significantly different in subjects with GDM (97.5 ng/L) as compared with healthy pregnant controls (102.9 ng/L). Fibroblast growth factor 21 significantly and positively correlated with markers of insulin resistance (increased homeostasis model assessment of insulin resistance, decreased adiponectin) and dyslipidemia (increased triglycerides, decreased high-density lipoprotein cholesterol) in univariate and multivariate analyses. Furthermore, FGF21 serum levels were highest in patients in the third tertile of homeostasis model assessment of insulin resistance. Fibroblast growth factor 21 is independently associated with markers of insulin resistance and an adverse lipid profile but is not dysregulated in GDM if patients are matched with controls for fasting insulin.

Serum levels of adipocyte fatty acid binding protein are increased in gestational diabetes mellitus.

OBJECTIVE: Adipocyte fatty acid binding protein (AFABP) was recently introduced as a novel adipokine, serum levels of which independently correlate with the development of the metabolic syndrome and cardiovascular disease in humans. In the current study, we investigated serum concentrations of AFABP in patients with gestational diabetes mellitus (GDM) as compared with healthy pregnant controls matched for gestational age and fasting insulin. DESIGN AND METHODS: AFABP was determined by ELISA in controls (n=80) and GDM patients (n=40) and correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation, in both groups. RESULTS: Median serum AFABP concentrations were significantly elevated in subjects with GDM (22.9 microg/l) as compared with healthy pregnant controls (18.3 microg/l; P<0.05). Furthermore, GDM was independently associated with AFABP concentrations in multiple regression analysis (P<0.05). In addition, markers of adiposity (body mass index, serum leptin), triglycerides and serum creatinine were independently associated with circulating AFABP (P<0.05). CONCLUSIONS: Maternal AFABP concentrations are significantly increased in GDM. The adipokine might contribute to the increased metabolic and cardiovascular risk of the disease.

Comparative analysis of conventional and an adaptive computer-based hypoglycaemia education programs.

Adaptive interactive computer-based education programs which can be personalized to patients' needs and skills might be more suitable for patients' training as compared to conventional ones. We tested whether there are differences between an adaptive and a conventional version of a computer-based hypoglycaemia education program concerning successful training and user friendliness. One hundred and twenty randomized diabetic patients were enrolled in this study. The two different programs were compared by using the following criteria: (1) the number of actions needed to get out of or prevent hypoglycaemia, (2) the need for external help, (3) the average time needed for completing one task and (4) user friendliness as determined by a questionnaire. Patients using the adaptive computer-based hypoglycaemia education program needed less actions to get out of or prevent hypoglycaemia, less external help and less time to finish tasks. Furthermore, the user friendliness of the adaptive computer program received a significantly better rating by the patients. The adaptive computer-based hypoglycaemia education program shows significantly better results as compared to a conventional one. Therefore, using adaptive computer-based programs might be helpful for education of patients.