Correlation between Overweight, Obesity, Gestational Diabetes Mellitus, Adipokines (Adipolin and Adiponectin), and Adverse Pregnancy Outcomes: A Pilot Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Subjects
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- Preterm birth = birth at less than 37 completed weeks of gestation, according to ICD 10 definitions (O60).
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- Gestational hypertension = systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or more, or both, on two occasions at least 4 h apart after 20 weeks of gestation in a woman with previously normal blood pressure [42].
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- Preeclampsia = gestational hypertension and proteinuria 300 mg or more per 24 h urine collection [42].
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- Neonatal hypoglycemia = blood glucose level < 36 mg/dL in the first 48 h of age [43].
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- Hyperbilirubinemia = neonates who need phototherapy based on their age according to clinical guidelines [44].
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- Respiratory distress = need for any form of positive pressure for optimal oxygenation.
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- NICU admission = treatment of respiratory distress.
2.2. Anthropometric Measurements
2.3. Biochemical Analyses
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Lean Healthy Group (LH)—24–28 Weeks (n = 92) | OW/OB without GDM—24–28 Weeks (n = 30) | OW/OB with GDM—24–28 Weeks (n = 44) | p-Value | ||
---|---|---|---|---|---|---|
LH vs. OW/OB without GDM | LH vs. OW/OB with GDM | OW/OB without GDM vs. OW/OB with GDM | ||||
Age, years | 31.05 ± 4.74 | 30.33 ± 5.32 | 31.84 ± 4.95 | >0.99 | 0.79 | 0.49 |
History of T2DM in first-degree family members | 7 (7.52%) | 4 (13.33%) | 14 (31.81%) | 0.46 | 0.0006 | 0.09 |
Personal history of GDM | 2 (2.17%) | 2 (6.66%) | 6 (13.63%) | 0.25 | 0.01 | 0.46 |
Education | ||||||
9–12 years | 26 (28.26%) | 5 (16.66%) | 13 (29.54%) | 0.23 | >0.99 | 0.27 |
>12 years | 66 (71.73%) | 23 (76.66%) | 27 (61.36%) | 0.33 | 0.24 | 0.21 |
Gestational age, weeks | 25.67 ± 1.31 | 25.93 ± 1.25 | 26.25 ± 1.34 | >0.99 | 0.053 | 0.95 |
Gestations | 1.82 ± 1.03 | 2.4 ± 1.03 | 1.95 ± 0.88 | 0.008 | 0.73 | 0.23 |
Parity | 1.52 ± 0.68 | 1.86 ± 0.73 | 1.68 ± 0.70 | 0.03 | 0.47 | 0.74 |
Pre-pregnancy BMI, kg/m2 | 21.21 ± 1.87 | 28.47 ± 3.12 | 30.57 ± 4.98 | <0.0001 | <0.0001 | >0.99 |
BMI, kg/m2 | 24.57 ± 2.28 | 31.03 ± 3.17 | 33.20 ± 4.75 | <0.0001 | <0.0001 | >0.90 |
GWG until OGTT, kg | 8.72 ± 3.68 | 6.89 ± 4.54 | 7.04 ± 4.78 | 0.22 | 0.09 | >0.99 |
Subscapular thickness, mm | 16.78 ± 6.31 | 23.76 ± 10.28 | 26.27 ± 8.44 | <0.0001 | <0.0001 | 0.79 |
Suprailiac, mm | 17.6 ± 7.18 | 23.52 ± 10.35 | 24.17 ± 9.27 | 0.0002 | <0.0001 | >0.99 |
CRP, mg/dL | 0.63 ± 0.53 | 0.90 ± 0.64 | 0.88 ± 0.74 | 0.07 | 0.15 | >0.99 |
Fasting glucose level, mg/dL | 79.58 ± 5.38 | 81.83 ± 5.99 | 97.68 ± 13.79 | 0.41 | <0.0001 | <0.0001 |
1 h glucose level, mg/dL | 123.3 ± 23.54 | 130.8 ± 24.08 | 178.5 ± 38.22 | 0.42 | <0.0001 | <0.0001 |
2 h glucose level, mg/dL | 102.5 ± 16.89 | 102.5 ± 23.6 | 141 ± 38.47 | 0.99 | <0.0001 | <0.0001 |
Insulin, mUI/l | 12.47 ± 22.34 | 20.42 ± 31.61 | 28.73 ± 58.23 | <0.0001 | <0.0001 | 0.74 |
HbA1c, % | 4.89 ± 0.32 | 4.97 ± 0.34 | 5.4 ± 0.59 | 0.32 | <0.0001 | 0.008 |
IR HOMA | 2.42 ± 4.33 | 4.24 ± 6.82 | 7.39 ± 15.81 | 0.0001 | <0.0001 | 0.14 |
T-cholesterol, mg/dL | 249.3 ± 36.95 | 243.6 ± 40.42 | 232 ± 49.42 | 0.78 | 0.059 | 0.46 |
HDL cholesterol, mg/dL | 75.96 ± 14.06 | 68.70 ± 15.36 | 66.35 ± 17.57 | 0.12 | 0.0009 | 0.98 |
LDL cholesterol, mg/dL | 156.3 ± 36.68 | 148.1 ± 37.96 | 139.4 ± 43.62 | 0.58 | 0.0501 | 0.61 |
Triglycerides, mg/dL | 188.3 ± 62.25 | 244.9 ± 82.81 | 238.2 ± 88.52 | 0.001 | 0.001 | >0.99 |
Adipolin, pg/mL | 5402 ± 581.1 | 5197 ± 706.2 | 5227 ± 1269 | 0.56 | >0.99 | 0.57 |
Adiponectin, ng/mL | 6845 ± 2134 | 5422 ± 2080 | 4735 ± 1800 | 0.0079 | <0.0001 | 0.61 |
Parameters | Lean Healthy Group (LH) (n = 92) | OW/OB without GDM (n = 30) | OW/OB with GDM (n = 44) | p-Value | ||
---|---|---|---|---|---|---|
LH vs. OW/OB without GDM | LH vs. OW/OB with GDM | OW/OB without GDM vs. OW/OB with GDM | ||||
Preterm birth ≦ 37 weeks | 6 (6.52%) | 2 (6.66%) | 6 (13.63%) | >0.99 | 0.20 | 0.46 |
Gestational hypertension | 1 (1.08%) | 2 (6.66%) | 10 (22.72%) | 0.14 | <0.0001 | 0.10 |
Preeclampsia | 2 (2.17%) | 1 (3.33%) | 0 | >0.99 | >0.99 | 0.40 |
Vaginal birth | 30 (32.6%) | 12 (40%) | 14 (31.81%) | 0.11 | 0.42 | 0.62 |
Cesarean section | 62 (67.4%) | 18 (60%) | 30 (68.19%) | 0.50 | >0.99 | 0.62 |
Parameters | Newborns From LH Mothers (n = 92) | Newborns From OW/OB Mothers without GDM (n = 30) | Newborns From OW/OB Mothers with GDM (n = 44) | p-Value | ||
---|---|---|---|---|---|---|
Newborns From LH Mothers vs. Newborns From OW/OB Mothers without GDM | Newborns From LH Mothers vs. Newborns From OW/OB Mothers with GDM | Newborns From OW/OB Mothers without GDM vs. Newborns From OW/OB Mothers with GDM | ||||
Birth weight, g | 3303 ± 381.8 | 3451 ± 549.8 | 3510 ± 561.1 | 0.29 | 0.04 | 0.85 |
Birth weight ≧ 4000 g | 2 (2.15%) | 3 (10%) | 10 (22.72%) | 0.09 | 0.0002 | 0.21 |
Male | 46 (50%) | 18 (60%) | 20 (45.45%) | 0.40 | 0.71 | 0.24 |
Apgar 1 min score, ≦8 | 5 (5.43%) | 1 (3.33%) | 3 (6.81%) | >0.99 | 0.71 | 0.64 |
Newborn length, cm | 53.05 ± 2.11 | 53.27 ± 2.33 | 53.34 ± 2.54 | >0.99 | >0.99 | >0.99 |
Head circumference, cm | 33,73 ± 1.33 | 34.17 ± 1.55 | 34.16 ± 1.44 | 0.77 | 0.59 | >0.99 |
Abdominal circumference, cm | 32.05 ± 1.51 | 32.18 ± 2.05 | 32.76 ± 2.37 | 0.94 | 0.10 | 0.39 |
Ponderal index | 2.20 ± 0.22 | 2.26 ± 0.19 | 2.29 ± 0.21 | 0.32 | 0.06 | 0.88 |
Adipolin pg/mL | 5580 ± 848.8 | 5792 ± 776.4 | 5785 ± 746.3 | 0.61 | 0.24 | >0.99 |
Adiponectin ng/mL | 35,340 ± 37,464 | 29,449 ± 23,448 | 19,842 ± 8070 | 0.72 | <0.0001 | 0.01 |
Neonatal hypoglycemia | 1 (1.08%) | 1 (3.33%) | 3 (6.81%) | 0.43 | 0.09 | 0.64 |
Jaundice, | 21 (22.82%) | 9 (30%) | 19 (43.18%) | 0.46 | 0.02 | 0.33 |
NICU admission (respiratory distress treatment) | 1 (1.08%) | 2 (6.66%) | 5 (11.36%) | 0.14 | 0.01 | 0.69 |
Adipokine | Adipolin | Adiponectin | Adipolin | Adiponectin | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Variables ↓ | OW/OB without GDM | Correlation Coefficient—r | p Value | Correlation Coefficient—r | p Value | OW/OB with GDM | Correlation Coefficient—r | p Value | Correlation Coefficient—r | p Value |
Pre-pregnancy BMI | −0.22 | 0.22 | −0.49 | 0.006 | −0.20 | 0.18 | −0.56 | 0.03 | ||
BMI at 24–28 weeks | −0.16 | 0.39 | −0.47 | 0.007 | −0.25 | 0.09 | −0.61 | 0.01 | ||
Subscapular thickness | −0.23 | 0.21 | −0.41 | 0.02 | −0.21 | 0.15 | −0.64 | 0.004 | ||
Suprailiac Thickness | −0.18 | 0.32 | −0.39 | 0.03 | −0.01 | 0.93 | −0.48 | 0.17 | ||
CRP | −0.19 | 0.31 | −0.41 | 0.02 | −0.20 | 0.17 | −0.48 | 0.13 | ||
Fasting glucose | −0.12 | 0.52 | 0.02 | 0.90 | −0.02 | 0.87 | −0.38 | 0.57 | ||
Insulin | −0.37 | 0.04 | −0.25 | 0.18 | 0.16 | 0.29 | −0.22 | 0.13 | ||
HbA1c | −0.11 | 0.55 | −0.08 | 0.65 | 0.03 | 0.83 | −0.66 | 0.002 | ||
IR HOMA | −0.35 | 0.053 | −0.21 | 0.25 | 0.15 | 0.32 | −0.53 | 0.07 | ||
TC | 0.23 | 0.20 | 0.55 | 0.001 | 0.11 | 0.47 | −0.12 | 0.23 | ||
HDL-C | 0.17 | 0.35 | 0.35 | 0.057 | −0.04 | 0.76 | 0.15 | 0.002 | ||
LDL-C | 0.14 | 0.43 | 0.41 | 0.02 | −0.002 | 0.98 | 0.06 | 0.69 | ||
TG | 0.02 | 0.88 | −0.09 | 0.61 | 0.10 | 0.50 | −018 | 0.21 | ||
adipolin | 0.10 | 0.56 | 0.03 | 0.82 | ||||||
adiponectin | 0.10 | 0.56 | 0.03 | 0.82 |
Maternal and Newborn Anthropometric Characteristics | Adipolin p-Value | Adiponectin p-Value | Insulin Level p-Value | IR HOMA p-Value | HDL-C p-Value | TC p-Value | Fasting Glucose p-Value |
---|---|---|---|---|---|---|---|
Pre-pregnancy BMI | 0.37 | 0.11 | 0.68 | 0.65 | 0.60 | 0.92 | 0.99 |
BMI at 24–28 weeks | 0.20 | 0.05 | 0.74 | 0.71 | 0.92 | 0.70 | 0.97 |
Birth weight | 0.45 | 0.60 | 0.44 | 0.44 | 0.24 | 0.42 | 0.63 |
Cranian circumference | 0.67 | 0.59 | 0.86 | 0.96 | 0.21 | 0.24 | 0.22 |
Abdominal circumference | 0.52 | 0.66 | 0.57 | 0.60 | 0.74 | 0.39 | 0.39 |
Ponderal index | 0.73 | 0.65 | 0.97 | 0.96 | 0.04 | 0.05 | 0.44 |
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© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Mihai, M.; Vladut, S.; Sonia-Teodora, L.; Laura Mihaela, S.; Victoria, N.; Irina Elena, M.; Claudiu, M. Correlation between Overweight, Obesity, Gestational Diabetes Mellitus, Adipokines (Adipolin and Adiponectin), and Adverse Pregnancy Outcomes: A Pilot Study. Medicina 2024, 60, 1544. https://doi.org/10.3390/medicina60091544
Mihai M, Vladut S, Sonia-Teodora L, Laura Mihaela S, Victoria N, Irina Elena M, Claudiu M. Correlation between Overweight, Obesity, Gestational Diabetes Mellitus, Adipokines (Adipolin and Adiponectin), and Adverse Pregnancy Outcomes: A Pilot Study. Medicina. 2024; 60(9):1544. https://doi.org/10.3390/medicina60091544
Chicago/Turabian StyleMihai, Muntean, Săsăran Vladut, Luca Sonia-Teodora, Suciu Laura Mihaela, Nyulas Victoria, Muntean Irina Elena, and Mărginean Claudiu. 2024. "Correlation between Overweight, Obesity, Gestational Diabetes Mellitus, Adipokines (Adipolin and Adiponectin), and Adverse Pregnancy Outcomes: A Pilot Study" Medicina 60, no. 9: 1544. https://doi.org/10.3390/medicina60091544