Association Between Retinol-Binding Protein 4 Concentrations and Gestational Diabetes Mellitus and Risk of Developing Metabolic Syndrome After Pregnancy
Restricted accessResearch articleFirst published online February, 2010
Association Between Retinol-Binding Protein 4 Concentrations and Gestational Diabetes Mellitus and Risk of Developing Metabolic Syndrome After Pregnancy
The aim of this study was to examine the association between plasma retinol-binding protein 4 (RBP4) and gestational diabetes mellitus (GDM) and the risk of developing metabolic syndrome after pregnancy. In a case-control study, 192 pregnant women (92 with GDM) were recruited. Gestational diabetes mellitus was diagnosed based on O’Sullivan and Mahan criteria. In all pregnancies, plasma RBP4 concentrations were measured. Retinol-binding protein 4 concentrations in GDM patients were significantly higher than the normal women. Retinol-binding protein 4 level equal to or more than 42 μg/mL could help predict the risk of developing GDM (sensitivity = 75.8%, specificity = 65.3%, P = .001). Concerning metabolic syndrome after pregnancy, in all participants, the prevalence of metabolic syndrome base on World Health Organization (WHO) criteria was 24%. After pregnancy, 32.6% of women with GDM had metabolic syndrome compared with 10.5% of those with healthy pregnancy (P = .001). Age more than 25 years, body mass index (BMI) more than 27 kg/cm2, and RBP4 concentrations were independent risk factors for GDM. Measurement of RBP4 together with the assessment of other risk factors could help identify women at risk of developing GDM.
Buchanan TA, Xiang A., Kjos SL, Watanabe R.What is gestational diabetes?Diabetes Care. 2007;30(suppl 2):S105-S111.
2.
Butte NFCarbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000;71(5 suppl):1256S-1261S.
3.
Catalano PM, Tyzbir ED, Wolfe RR, et al. Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am J Physiol. 1993;264(1 pt 1): E60-E67.
4.
Di Cianni G. , Miccoli R., Volpe L., Lencioni C., Del Prato S.Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003;19(4):259-270.
5.
Buchanan TA, Xiang AHGestational diabetes mellitus. J Clin Invest. 2005;115(3):485-491.
6.
Kim C., Newton KM, Knopp RHGestational diabetes and the incidence of type 2 diabetes: a systematic review . Diabetes Care. 2002;25(10):1862-1868.
7.
Ben-Haroush A., Yogev Y., Hod M.Epidemiology of gestational diabetes mellitus and its association with type 2 diabetes. Diabet Med. 2004;21(2):103-113.
Lafontan M., Berlan M.Do regional differences in adipocyte biology provide new pathophysiological insights? Trends Pharmacol Sci. 2003;24(6):276-283.
10.
Zhang Y., Proenca R., Maffei M., Barone M., Leopold L., Friedman JMPositional cloning of the mouse obese gene and its human homologue. Nature. 1994;372(6505):425-432.
11.
Hossein-Nezhad A., Maghbooli Zh , Larijani B.The incidence of diabetes and abnormal glucose tolerance in women at early postpartum with previous gestational diabetes . Iranian J Diab Lipid Disord. 2004;4(1):27-34.
12.
Innes KE, Wimsatt JHPregnancy-induced hypertension and insulin resistance: evidence for a connection . Acta Obstet Gynecol Scand. 1999;78(4):263-284.
13.
ACOG Committee on Practice Bulletins-Obstetrics.ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Obstet Gynecol. 2002;99(1):159-167.
14.
Cho NH, Jang HC, Park HK, Cho YWWaist circumference is the key risk factor for diabetes in Korean women with history of gestational diabetes. Diabetes Res Clin Pract. 2006;71(2): 177-183.
15.
Cho NH, Lim S., Jang HC, Park HK, Metzger BEElevated homocysteine as a risk factor for the development of diabetes in women with a previous history of gestational diabetes mellitus: a 4-year prospective study. Diabetes Care. 2005;28(11): 2750-2755.
16.
Jang HC, Yim CH, Han KO, et al. Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum. Diabetes Res Clin Pract. 2003;61(2): 117-124.
17.
Metzger BE, Cho NH, Roston SM, Radvany R.Prepregnancy weight and antepartum insulin secretion predict glucose tolerance five years after gestational diabetes mellitus. Diabetes Care . 1993;16(12):1598-1605.
18.
Trayhurn P. , Wood ISAdipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr. 2004 ; 92(3):347-355.
19.
Yang Q., Graham TE, Mody N., et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature. 2005 ;436(7049):356-362.
20.
Muoio DM, Newgard CBMetabolism: A is for adipokine. Nature. 2005 ;436(7049):337-338.
21.
Kahn BBDietary regulation of glucose transporter gene expression: tissue specific effects in adipose cells and muscle. J Nutr. 1994;124(8 suppl):1289S-1295S.
22.
Janke J., Engeli S., Boschmann M., et al. Retinol-binding protein 4 in human obesity. Diabetes. 2006;55(10):2805-2810.
23.
Kautzky-Willer A., Pacini G., Tura A., et al. Increased plasma leptin in gestational diabetes. Diabetologia. 2001;44(2): 164-172.
24.
Graham TE, Yang Q., Blüher M., et al. Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med. 2006;354(24):2552-2563.
25.
Cho YM, Youn BS, Lee H., et al. Plasma retinol-binding protein-4 concentrations are elevated in human subjects with impaired glucose tolerance and type 2 diabetes. Diabetes Care. 2006;29(11):2457-2461.
26.
Ryan EA, Ó Sullivan MJ , Skyler JSInsulin action during pregnancy. Studies with the euglycemic clamp technique. Diabetes. 1985;34(4):380-389.
27.
Kautzky-Willer A., Prager R., Waldhäusl W., et al. Pronounced insulin resistance and inadequate B-cell secretion in lean gestational diabetes mellitus during and after pregnancy. Diabetes Care. 1997;20(11):1717-1723.
28.
Flegal KM, Carroll MD, Ogden CL, Johnson CLPrevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288(14):1723-1727.
29.
Kuhl C.Insulin secretion and insulin resistance in pregnancy and GDM. Implications for diagnosis and management. Diabetes. 1991 ;40(suppl 2):18-24.
30.
World Health Organization.Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva: World Health Organization; 1999.
31.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RCHomeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetes. 1985; 28(7):412-419.
32.
American Diabetes Association.Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27(suppl 1):S5-S10.
33.
Ferrannini E., Gastaldelli A., Miyazaki Y., Matsuda M., Mari A., DeFronzo RABeta-cell function in subjects spanning the range from normal glucose tolerance to overt diabetes: a new analysis. J Clin Endocrinol Metab. 2005;90(1):493-500.
34.
Antuna-Puente B., Feve B., Fellahi S., Bastard JPAdipokines: the missing link between insulin resistance and obesity. Diab Metab. 2008;34(1):2-11.
35.
Paolisso G. , Tataranni PA, Foley JE, Bogardus C., Howard BV, Ravussin E.A high concentration of fasting plasma non-esterified fatty acids is a risk factor for the development of NIDDM. Diabetologia. 1995;38(10):1213-1217.
36.
Unger RH, Zhou YT, Orci L.Regulation of fatty acid homeostasis in cells: novel role of leptin. Proc Natl Acad Sci U S A. 1999;96(5):2327-2332.
37.
Cnop M., Welsh N., Jonas JC, Jorns A., Lenzen S., Eizirik DLMechanisms of pancreatic beta-cell death in type 1 and type 2 diabetes: many differences, few similarities. Diabetes. 2005 ; 54(suppl 2):S97-S107.
38.
Eizirik DL, Flodstrom M., Karlsen AE, Welsh N.The harmony of the spheres: inducible nitric oxide synthase and related genes in pancreatic beta cells. Diabetologia. 1996 ; 39(8):875-890.
39.
Chan CB, De Leo D., Joseph JW, et al. Increased uncoupling protein-2 levels in beta-cells are associated with impaired glucose-stimulated insulin secretion: mechanism of action. Diabetes. 2001;50(6):1302-1310.
40.
Choi SH, Kwak SH, Youn BS, et al. High plasma retinol binding protein-4 and low plasma adiponectin concentrations are associated with severity of glucose intolerance in women with previous gestational diabetes mellitus. J Clin Endocrinol Metab. 2008;93(8):3142-3148.
41.
Lewandowski KC, Stojanovic N., Bienkiewicz M., et al. Elevated concentrations of retinol-binding protein-4 (RBP-4) in gestational diabetes mellitus: negative correlation with soluble vascular cell adhesion molecule-1 (sVCAM-1). Gynecol Endocrinol. 2008;24(6):300-305.
42.
Chan TF, Chen HS, Chen YC, et al. Increased serum retinol-binding protein 4 concentrations in women with gestational diabetes mellitus. Reprod Sci. 2007;14(2):169-174.
43.
Ueland T., Dalsoren T., Voldner N., Godang K., Henriksen T., Bollerslev J.Retinol-binding protein-4 is not strongly associated with insulin sensitivity in normal pregnancies. Eur J Endocrinol. 2008 ;159(1):49-54.
44.
Garvey WT, Maianu L., Zhu JH, Hancock JA, Golichowski AMMultiple defects in the adipocyte glucose transport system cause cellular insulin resistance in gestational diabetes. Heterogeneity in the number and a novel abnormality in subcellular localization of GLUT4 glucose transporters . Diabetes. 1993;42(12):1773-1785.
45.
Maghbooli Z. , Hossein-Nezhad A., Rahmani M., Shafaei AR, Larijani B.Relationship between leptin concentration and insulin resistance. Horm Metab Res. 2007 ;39(12):903-907.
46.
Retnakaran R., Hanley AJ, Raif N., Connelly PW, Sermer M., Zinman B.Reduced adiponectin concentration in women with gestational diabetes: a potential factor in progression to type 2 diabetes . Diabetes Care. 2004;27(3):799-800.
