Role of Adipokines and Other Inflammatory Mediators in Gestational Diabetes Mellitus and Previous Gestational Diabetes Mellitus

Figure 1

Molecular structure of the main adipokines produced by adipose tissue in GDM and pGDM. Adiponectin is a 244-amino-acid polypeptide that decreases as adipose tissue increases; it enhances insulin action and is decreased in pGDM and GDM. Leptin is a 167-amino-acid protein; it causes insulin action to increase and its levels show variability with respect to GDM and pGDM. Resistin (or adipose tissue-specific secretory factor) has 108 amino acids in the prepeptide form; its action on insulin has yet to be clarified. RBP-4 is a 183-amino-acid protein which reduces insulin action. Both resistin and RBP-4 levels appear increased, decreased, or unaltered in GDM but are uniformly increased in pGDM. The visfatin molecule consists of 491 amino acids; it facilitates insulin action and increases in GDM, while its actions in pGDM need further clarification.