Regulation of the novel adipokines/ hepatokines fetuin A and fetuin B in gestational diabetes mellitus.

OBJECTIVE: Fetuin B has recently been introduced as a novel adipokine/hepatokine which is significantly increased in hepatic steatosis and mediates impaired insulin action, as well as glucose intolerance. However, regulation of fetuin B in gestational diabetes mellitus (GDM), as well as its longitudinal changes in the peripartum period, have not been elucidated, so far. DESIGN AND METHODS: Circulating fetuin A and fetuin B were quantified in 74 women with GDM and 74 healthy and gestational age-matched controls by enzyme-linked immunosorbent assay during pregnancy (median gestational age: 201days). Furthermore, fetuin B was quantified during pregnancy as compared to postpartum levels in a follow-up study (median time after delivery: 4years and 115days).
RESULTS: Median [interquartile range] serum fetuin B levels were significantly higher in women with GDM (4.8 [1.7] mg/l) as compared to non-diabetic pregnant controls (4.3 [1.2] mg/l) (p=0.013) during pregnancy. In multivariate analysis, GDM status, insulin resistance, and fetuin A were independent and positive predictors of circulating fetuin B. Furthermore, fetuin B serum concentrations significantly decreased after delivery from 4.6 [1.7] mg/l (prepartum) to 3.0 [2.2] mg/l (postpartum) in all women (p<0.001).
CONCLUSIONS: Women with GDM have significantly higher fetuin B levels as compared to healthy pregnant control women and GDM status, insulin resistance, and fetuin A positively predict circulating fetuin B. Postpartum fetuin B is decreased as compared to prepartum values suggesting a placental co-secretion of this novel adipokine/hepatokine. Further studies need to elucidate factors contributing to fetuin B regulation in humans, as well as the pathophysiological significance of fetuin B upregulation in GDM.