The Association of Glycemic Markers with Plasma Adipocytokine Levels in Women with Gestational Diabetes

Abstract

Introduction: Alterations in the synthesis of cytokines have been demonstrated in gestational diabetes (GDM), but the association of cytokines with short- and long-term glycemic markers has not been defined clearly. In this study, the variations in the plasma levels of visfatin, TNF-α, IL-1β, IL-6, and IL-10 were investigated and theirassociations with glycemic markers -HbA1C, fructosamine, 1,5-anhydro-D-glucitol (1,5-AG), and continuous glucose monitoring system (CGMS) parameters were evaluated. Material and methods: 33 pregnant women with GDM, and 20 pregnant women without any maternal and fetal disorder were comprised in the study. Three of the 33 women diagnosed with GDM required insulin therapy were excluded from the study. The visfatin, TNF-α, IL-1β, IL-6 and IL-10 and 1,5-AG were determined by ELISA. HbA1C% and fructosamine were also evaluated. Continuous glucose monitoring system (CGMS) was applied to the women with GDM. Results: Serum IL-6 and IL-1β levels were significantly high in GDM compared to controls (p=0.039, and p=0.04, respectively). An increase in TNF-α level by approximately 33% did not reach significant level. No significant interactions between BMI and cytokines were found. Visfatin levels were correlated with 1,5 AG (r=0.557, p=0.001) and TNF-α concentration was correlated with HbA1C (r=0.341, p=0.050). IL-1β was associated with both MAD% and average glucose which are indices of CGMS (p=0.004 and p=0.008). Conclusions: Increased IL-6, IL-1β, and TNF-α, and their correlation with short- or longterm glycemic markers present an evidence for the roles of these cytokines and visfatin on carbohydrate metabolism in the course of gestational process and gives a priority to proinflammatory cytokine profile in gestational diabetes.