The protein hormone adiponectin may be partially responsible for increased risk of gestational diabetes in overweight and obese pregnant women. The protein works with various aspects of metabolic functions, including oxidation of fatty acids and regulating glucose. According to a study published in Diabetes Care, women with lower than normal levels of adiponectin are at least six times more likely to suffer from gestational diabetes. 

Kaiser Permanente electronic medical records were used in the study. More than 4,000 medical records were identified for women who submitted blood samples (voluntarily) between 1985 and 1996. The blood samples were collected during prenatal care. Of the 4,000 electronic records – researchers found slight more than 250 cases of gestational diabetes. These cases were partnered with 497 controls from the same group of women who did not develop gestational diabetes. 

Adiponectin levels were measured and placed in one of four quartiles with Quartile 1 having the lowest levels of adiponectin and Quartile 4 having the highest levels of adiponectin. A measurement of 10.29 mg/dL is considered normal. Based on these measurements, overweight and obese pregnant patients who fell in Quartiles 1 and 2 were more nearly seven times more likely to develop gestational diabetes. Women of normal weight were also affected with higher numbers of gestational diabetes reports in normal weight women with low adiponectin levels. 

Researchers now know a simple blood test for adiponectin levels could provide an early warning of potential gestational diabetes risk for pregnant women, but understanding the risk is not enough. Additional research is needed to determine how adiponectin affects the development of gestational diabetes and why some women have lower than normal levels even if weight is not a contributing factor. 

Source: Monique M. Hedderson, PHD, Jeanne Darbinian, MPH, Peter J. Havel, DVM, PHD, Charles P. Quesenberry, PHD, Sneha Sridhar, MPH, Samantha Ehrlich, PHD and Assiamira Ferrara, MD, PHD. Low Prepregnancy Adiponectin Concentrations Are Associated With a Marked Increase in Risk for Development of Gestational Diabetes Mellitus. Diabetes Care August 29, 2013. doi: 10.2337/dc13-0389.