Adiponectin and beta cell dysfunction in gestational diabetes : pathophysiological implications

• Published in: Diabetologia 2005-05, Vol.48 (5), p.993-1001
• Main Authors: RETNAKARAN, R, HANLEY, A. J. G, RAIF, N, HIRNING, C. R, CONNELLY, P. W, SERMER, M, KAHN, S. E, ZINMAN, B
• Format: Article
• Language: English
• Subjects: Adipocytes; Adiponectin; Adult; Biological and medical sciences; Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetes, Gestational - blood; Diabetes, Gestational - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology; Endocrinopathies; Fasting; Female; Gestational Age; Gestational diabetes; Glucose Tolerance Test; Homeostasis; Humans; Insulin - metabolism; Insulin Resistance; Insulin Secretion; Intercellular Signaling Peptides and Proteins - blood; Islets of Langerhans - metabolism; Islets of Langerhans - physiopathology; Medical sciences; Pathogenesis; Pregnancy; Pregnancy Trimester, Third; Proteins
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-005-1710-x

Gestational diabetes mellitus (GDM) identifies a population of young women at high risk of developing type 2 diabetes and thus provides an excellent model for studying early events in the natural history of this disease. Adiponectin, a novel adipocyte-derived protein with insulin-sensitising properties, has been proposed as a factor linking insulin resistance and beta cell dysfunction in the pathogenesis of type 2 diabetes. We conducted the current investigation to determine whether adiponectin is associated with beta cell dysfunction in GDM. We studied 180 women undergoing OGTT in late pregnancy. Based on the OGTT results, participants were stratified into three groups: (1) NGT (n=93); (2) IGT (n=39); and (3) GDM (n=48). First-phase insulin secretion was determined using a validated index previously proposed by Stumvoll. Insulin sensitivity was assessed using the validated OGTT insulin sensitivity index of Matsuda and DeFronzo (IS(OGTT)). To evaluate beta cell function in relation to ambient insulin sensitivity, an insulin secretion-sensitivity index (ISSI) was derived from the product of the Stumvoll index and the IS(OGTT), based on the existence of the predicted hyperbolic relationship between these two measures. Mean ISSI was highest in the NGT group (6,731), followed by that in the IGT group (4,976) and then that in the GDM group (3,300) (overall p