Background/Aims: Visfatin is a novel adipokine with insulinomimetic properties that increases in diabetes. However, for gestational diabetes mellitus (GDM) there are conflicting reports. Recent studies have reported a positive association of serum ferritin concentrations with insulin resistance. Thus, we assessed serum levels of visfatin in pregnant women with varying degrees of glucose tolerance and investigated the possible interaction of visfatin with parameters of iron metabolism. Methods: Visfatin levels were measured at 24-28 weeks of gestation in 88 women who were divided into three groups according to their response to a 50-gram glucose challenge test and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance (IGT) group (n = 30) and GDM group (n = 30). Results: Visfatin levels were significantly higher in the GDM and IGT group than in control (p < 0.001 for GDM vs. control, and p = 0.004 for IGT vs. control). Serum visfatin was significantly associated with serum ferritin, insulin, age, gravidity, and body mass index. In a linear regression model, the covariates explained only 17% of variability of serum visfatin concentration. Body mass index (p < 0.001) contributed independently to visfatin variance. Conclusion: Serum visfatin concentration is significantly higher in GDM and is correlated with ferritin levels.

Keywords:
Visfatin, Insulin resistance, Ferritin, Gestational diabetes mellitus
1.
Fukuhara A, Matsuda M, Nishizawa M, Segawa K, Tanaka M, Kishimoto K, Matsuki Y, Murakami M, Ichisaka T, Murakami H, Watanabe E, Takagi T, Akiyoshi M, Ohtsubo T, Kihara S, Yamashita S, Makishima M, Funahashi T, Yamanaka S, Hiramatsu R, Matsuzawa Y, Shimomura I: Visfatin: A protein secreted by visceral fat that mimics the effects of insulin. Science 2005;307:426-430.
2.
Sethi JK, Vidal-Puig A: Visfatin: The missing link between intra-abdominal obesity and diabetes? Trends Mol Med 2005;11:344-347.
3.
Morgan SA, Bringolf JB, Seidel ER: Visfatin expression is elevated in normal human pregnancy. Peptides 2008;29:1382-1389.
4.
Malamitsi-Puchner A, Briana DD, Boutsikou M, Kouskouni E, Hassiakos D, Gourgiotis D: Perinatal circulating visfatin levels in intrauterine growth restriction. Pediatrics 2007;119:e1314-e1318.
5.
Fasshauer M, Waldeyer T, Seeger J, Schrey S, Ebert T, Kratzsch J, Lossner U, Bluher M, Stumvoll M, Faber R, Stepan H: Serum levels of the adipokine visfatin are increased in pre-eclampsia. Clin Endocrinol (Oxf) 2008;69:69-73.
6.
Kendal-Wright CE, Hubbard D, Bryant-Greenwood GD: Chronic stretching of amniotic epithelial cells increases pre-B cell colony-enhancing factor (PBEF/visfatin) expression and protects them from apoptosis. Placenta 2008;29:255-265.
7.
Haider DG, Schaller G, Kapiotis S, Maier C, Luger A, Wolzt M: The release of the adipocytokine visfatin is regulated by glucose and insulin. Diabetologia 2006;49:1909-1914.
8.
Lopez-Bermejo A, Chico-Julia B, Fernández-Balsells M, Recasens M, Esteve E, Casamitjana R, Ricart W, Fernández-Real JM: Serum visfatin increases with progressive β-cell deterioration. Diabetes 2006;55:2871-2875.
9.
Chen MP, Chung FM, Chang DM, Tsai JC, Huang HF, Shin SJ, Lee YJ: Elevated plasma level of visfatin/pre-B cell colony-enhancing factor in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab 2006;91:295-299.
10.
Berndt J, Kloting N, Kralisch S, Kovacs P, Fasshauer M, Schon MR, Stumvoll M, Bluher M: Plasma visfatin concentrations and fat depot-specific MRNA expression in humans. Diabetes 2005;54:2911-2916.
11.
Krzyzanowska K, Krugluger W, Mittermayer F, Rahman R, Haider D, Shnawa N, Schernthaner G: Increased visfatin concentrations in women with gestational diabetes mellitus. Clin Sci (Lond) 2006;110:605-609.
12.
Ma Y, Cheng Y, Wang J, Cheng H, Zhou S, Li X: The changes of visfatin in serum and its expression in fat and placental tissue in pregnant women with gestational diabetes. Diabetes Res Clin Pract 2010;90:60-65.
13.
Lewandowski KC, Stojanovic N, Press M, Tuck SM, Szosland K, Bienkiewicz M, Vatish M, Lewinski A, Prelevic GM, Randeva HS: Elevated serum levels of visfatin in gestational diabetes: a comparative study across various degrees of glucose tolerance. Diabetologia 2007;50:1033-1037.
14.
Mazaki-Tovi S, Romero R, Kusanovic JP, Vaisbuch E, Erez O, Than NG, Chaiworapongsa T, Nhan-Chang CL, Pacora P, Gotsch F, Yeo L, Kim SK, Edwin SS, Hassan SS, Mittal P: Visfatin in human pregnancy: maternal gestational diabetes vis-à-vis neonatal birthweight. J Perinat Med 2009;37:218-231.
15.
Chan TF, Chen YL, Lee CH, Chou FH, Wu LC, Jong SB, Tsai EM: Decreased plasma visfatin concentrations in women with gestational diabetes mellitus. J Soc Gynecol Investig 2006;13:364-367.
16.
Haider DG, Handisurya A, Storka A, Vojtassakova E, Luger A, Pacini G, Tura A, Wolzt M, Kautzky-Willer A: Visfatin response to glucose is reduced in women with gestational diabetes mellitus. Diabetes Care 2007;30:1889-1891.
17.
American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2005;28(suppl 1):S37-S42.
18.
Ferrannini E: Insulin resistance, iron, and the liver. Lancet 2000;355:2181-2182.
19.
Lao TT, Chan PL, Tam KF: Gestational diabetes mellitus in the last trimester - a feature of maternal iron excess? Diabet Med 2001;18:218-223.
20.
Scholl TO: Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr 2005;81:1218S-1222S.
21.
Siddappa AM, Rao R, Long JD, Widness JA, Georgieff MK: The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology 2007;92:73-82.
22.
Rao R, Georgieff MK: Iron in fetal and neonatal nutrition. Semin Fetal Neonatal Med 2007;12:54-63.
23.
Rajpathak SN, Crandall JP, Wylie-Rosett J, Kabat GC, Rohan TE, Hu FB: The role of iron in type 2 diabetes in humans. Biochim Biophys Acta 2009;1790:671-681.
24.
Wilson JG, Lindquist JH, Grambow SC, Crook ED, Maher JF: Potential role of increased iron stores in diabetes. Am J Med Sci 2003;325:332-339.
25.
Fernández-Real JM, Ricart-Engel W, Arroyo E, Balanca R, Casamitjana-Abella R, Cabrero D, Fernández-Castaner M, Soler J: Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care 1998;21:62-68.
26.
Fernández-Real JM, Lopez-Bermejo A, Ricart W: Cross-talk between iron metabolism and diabetes. Diabetes 2002;51:2348-2354.
27.
McClain DA, Abraham D, Rogers J, Brady R, Gault P, Ajioka R, Kushner JP: High prevalence of abnormal glucose homeostasis secondary to decreased insulin secretion in individuals with hereditary haemochromatosis. Diabetologia 2006;49:1661-1669.
28.
Iwasaki T, Nakajima A, Yoneda M, Yamada Y, Mukasa K, Fujita K, Fujisawa N, Wada K, Terauchi Y: Serum ferritin is associated with visceral fat area and subcutaneous fat area. Diabetes Care 2005;28:2486-2491.
29.
Chen X, Scholl TO, Stein TP: Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women: The Camden Study. Diabetes Care 2006;29:1077-1082.
30.
Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982;144:768-773.
31.
Rezvan N, Hosseinzadeh-Attar MJ, Masoudkabir F, Moini A, Janani L, Mazaherioun M: Serum visfatin concentrations in gestational diabetes mellitus and normal pregnancy. Arch Gynecol Obstet 2012;285:1257-1262.
32.
Klebanoff MA, Shiono PH, Selby JV, Trachtenberg AI, Graubard BI: Anemia and spontaneous preterm birth. Am J Obstet Gynecol 1991;164:59-63.
33.
Lao TT, Tam KF: Maternal serum ferritin and gestational impaired glucose tolerance. Diabetes Care 1997;20:1368-1369.
34.
Lao TT, Ho LF: Impact of iron deficiency anemia on prevalence of gestational diabetes mellitus. Diabetes Care 2004;27:650-656.
35.
Sharifi F, Ziaee A, Feizi A, Mousavinasab N, Anjomshoaa A, Mokhtari P: Serum ferritin concentration in gestational diabetes mellitus and risk of subsequent development of early postpartum diabetes mellitus. Diabetes Metab Syndr Obes 2010;3:413-419.
36.
Afkhami-Ardekani M, Rashidi M: Iron status in women with and without gestational diabetes mellitus. J Diabetes Complications 2009;23:194-198.
37.
Bo S, Menato G, Villois P, Gambino R, Cassader M, Cotrino I, Cavallo-Perin P: Iron supplementation and gestational diabetes in midpregnancy. Am J Obstet Gynecol 2009;201:158.e1-e6.
38.
Fernández-Real JM, Moreno JM, Chico B, Lopez-Bermejo A, Ricart W: Circulating visfatin is associated with parameters of iron metabolism in subjects with altered glucose tolerance. Diabetes Care 2007;30:616-621.
39.
Davis RJ, Corvera S, Czech MP: Insulin stimulates cellular iron uptake and causes the redistribution of intracellular transferrin receptors to the plasma membrane. J Biol Chem 1986;261:8708-8711.
40.
Fernández-Real JM, Ricart W: Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev 2003;24:278-301.
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2013
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