Review Article

Maternal Circulating Concentrations of Tumor Necrosis Factor-Alpha, Leptin, and Adiponectin in Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies.

SNP ID/authorGDM/controlAge (years)BMI (kg/m2)Insulin therapy/diet controlInsulin (mIU/mL)Gestational age at blood collection

TNF-α
Altinova et al. [13]34/31GDM 31.5 ± 4.3;
control 29.0 ± 4.9
GDM 29.5 ± 3.5;
control 28.0 ± 4.3
Insulin therapy: 5
Diet control: 29
GDM 58.7 ± 15.5;
control 36.9 ± 5.8
Third trimester
Cseh et al. [9]30/11GDM 28.00 ± 2.70;
control 26.00 ± 2.60
GDM 33.40 ± 6.40;
control 25.40 ± 2.60
Insulin therapy: allNPThird trimester
Gao et al. [14]22/20GDM 30.97 ± 3.64;
control 28.80 ± 2.62
GDM 23.92 ± 3.51;
control 21.83 ± 2.33
Insulin therapy: yes, but not allNPGDM 29.28 ± 2.79 w;
control 28.00 ± 3.09 w
Gauster et al. [15]26/241GDM 29.2 ± 6.2;
obese-control 27.6 ± 5.6;
lean-control 28.5 ± 6.0
GDM 35.8 ± 1.5;
lean-control 22.2 ± 3.5;
obese-control 34.6 ± 7.4
Insulin therapy: yes, but not allGDM 30.6 ± 20.3;
lean-control 12.5 ± 6.4;
obese-control 23.3 ± 13.1
GDM 38.5 ± 0.7 w;
control 38.7 ± 0.6 w
Kinalski et al. [16]80/30GDM 29.0 ± 4.9;
control 28.2 ± 6.0
GDM 27.11 ± 4.58;
control 25.61 ± 3.41
Insulin therapy: no
Diet control: all
GDM 11.03 ± 12.18;
control 5.46 ± 2.02
Third trimester
Kirwan et al. [4]5/10GDM 29 ± 2;
lean-control 33 ± 2;
obese-control 30 ± 1
GDM 30.8 ± 2.8;
obese-control 27.3 ± 2.4;
Lean-control 19.8 ± 1.0
NPObese-GDM 27.5 ± 5.6;
lean-control 10.7 ± 0.9
Between 34 and 36 w
McLachlan et al. [17]19/19GDM 33 ± 1;
control 33 ± 1
GDM 31.5 ± 1.3;
control 31.6 ± 1.3
Insulin therapy: 5
Diet control: 14
NPThird trimester
Radaelli et al. [7]7/8NPGDM 39.7 ± 2.6;
control 34.0 ± 3.3
Insulin therapy: 7GDM 58.7 ± 15.5;
control 36.9 ± 5.8
GDM 38.5 ± 0.5 w;
control 38.9 ± 0.4 w
Saucedo et al. [18]60/60GDM 31.9 ± 5.6;
control 24.8 ± 6.4
GDM 30.2 ± 4.9;
control 28.4 ± 7.3
Insulin therapy: yes, but not allGDM 61.1 ± 40.3;
control 50.7 ± 33.3
At 30 w
Winkler et al. [19]30/35GDM 28.0 ± 2.7;
control 26.0 ± 2.6
GDM 33.4 ± 6.4;
control 25.4 ± 2.6
Insulin therapy: allNPGDM 27.6 ± 6.1 w;
control 22.5 ± 10.8 w
Leptin
Chen et al. [20]20/20 GDM 31.2 ± 6.3;
control 28.7 ± 5.3
GDM 29.2 ± 5.8;
control 27.8 ± 4.0
NPGDM 24.12 ± 14.4;
control 15.95 ± 7.1
GDM 37.1 ± 2.3 w;
control 39.0 ± 1.7 w
Cseh et al. [9]30/11GDM 28.00 ± 2.70;
control 26.00 ± 2.60
GDM 33.40 ± 6.40;
control 25.40 ± 2.60
Insulin therapy: allNPThird trimester
Festa et al. [21]55/166GDM 29.4 ± 5.9;
control 26.4 ± 5.2
GDM 28.8 ± 4.7;
control 25.9 ± 4.3
Insulin therapy: no
Diet control: all
GDM 67.0 ± 34.7;
control 59.2 ± 35.8
GDM 26.0 ± 5.0 w;
control 25.4 ± 1.5 w
Gao et al. [14]22/20GDM 30.97 ± 3.64;
control 28.80 ± 2.62
GDM 23.92 ± 3.51;
Control 21.83 ± 2.33
Insulin therapy: yes, but not allNPGDM 29.28 ± 2.79 w;
control 28.00 ± 3.09 w
Gauster et al. [15]26/241GDM 29.2 ± 6.2;
obese-control 27.6 ± 5.6;
lean-control 28.5 ± 6.0
GDM 35.8 ± 1.5;
lean-control 22.2 ± 3.5;
obese-control 34.6 ± 7.4
Insulin therapy: yes, but not allGDM 30.6 ± 20.3;
lean-control 12.5 ± 6.4;
obese-control 23.3 ± 13.1
GDM 38.5 ± 0.7 w;
control 38.7 ± 0.6 w
Georgiou et al. [22]14/14GDM 33.8 ± 5.0;
control 32.6 ± 3.4
GDM 28.2 ± 8.4;
control 24.7 ± 5.1
Insulin therapy: 6
Diet control: 8
GDM 14.3 ± 8.3;
control 8.9 ± 3.7
At 28 w
Horosz et al. [23]86/48GDM 31.8 ± 4.3;
control 30.7 ± 3.5
GDM 28.39 ± 5.32;
control 25.40 ± 2.72
Insulin therapy: yes, but not allGDM 9.77 ± 4.94;
control 8.10 ± 3.32
Between 27 and 32 w
Kautzky-Willer et al. [24]55/25GDM 30.9 ± 0.9;
control 29.6 ± 1.9
GDM 28.0 ± 0.9;
control 28.1 ± 0.8
Insulin therapy: yes, but not allGDM 127.2 ± 13.2;
control 72.0 ± 12.3
At 28 w
Kirwan et al. [4]5/10GDM 29 ± 2;
lean-Control 33 ± 2;
obese-Control 30 ± 1
GDM 30.8 ± 2.8;
obese-control 7.3 ± 2.4;
lean-control 19.8 ± 1.0
NPObese-GDM 27.5 ± 5.6;
lean-control 10.7 ± 0.9
Between 34 and 36 w
Kleiblova et al. [25] 10/13GDM 34.6 ± 2.5;
control 33.1 ± 1.3
GDM 30.1 ± 2.3;
control 22.7 ± 0.9
Insulin therapy: allGDM 144.8 ± 64.56;
control 23.4 ± 1.96
GDM 268.9 ± 4.2 d;
control 276.9 ± 1.6 d
McLachlan et al. [17]19/19GDM 33 ± 1;
control 33 ± 1
GDM 31.5 ± 1.3;
control 31.6 ± 1.3
Insulin therapy: 5
Diet control: 14
NPThird trimester
Mokhtari et al. [26]26/22GDM 32.69 ± 6.85;
control 28.18 ± 8.93
GDM 28.51 ± 3.66;
control 27.24 ± 4.06
NPNPThird trimester
Vitoratos et al. [27]17/17GDM 33 ± 2.3;
control 34 ± 2.7
GDM 36.74 ± 6.52;
control 34.86 ± 5.91
NPGDM 21.29 ± 10.16;
control NP
At 29 w and 33 w
Okereke et al. [28]7/8GDM 29.9 ± 4.1;
control 31.6 ± 3.4
GDM 28.7 ± 6.3;
control 26.2 ± 4.5
Insulin therapy: allGDM 0.046 ± 0.02;
control 0.089 ± 0.03
Between 34 and 36 w
Radaelli et al. [7]7/8NPGDM 39.7 ± 2.6;
control 34.0 ± 3.3
Insulin therapy: allGDM 58.7 ± 15.5;
control 36.9 ± 5.8
GDM 38.5 ± 0.5 w;
control 38.9 ± 0.4 w
Ranheim et al. [29]22/29NPGDM 31.4 ± 1;
control 28.3 ± 0.6
Insulin therapy: 30%
Diet control: 70%
GDM 389 ± 84;
control 75 ± 6
GDM 38.1 ± 0.3 w;
control 38.5 ± 0.3 w
Saucedo et al. [18]60/60GDM 31.9 ± 5.6;
control 24.8 ± 6.4
GDM 30.2 ± 4.9;
control 28.4 ± 7.3
Insulin therapy: yes, but not allGDM 61.1 ± 40.3;
control 50.7 ± 33.3
At 30 w
Yilmaz et al. [30]56/42GDM 31.45 ± 4.92;
control 28.1 ± 4.02
GDM 29.01 ± 4.93;
control 28.02 ± 4.27
NPGDM 14.62 ± 12.04;
control 8.81 ± 4.28
GDM 30.85 ± 3.39 w;
control 31.2 ± 3.69 w
Adiponectin
Altinova et al. [13]34/31GDM 31.5 ± 4.3;
control 29.0 ± 4.9
GDM 29.5 ± 3.5;
control 28.0 ± 4.3
Insulin therapy: 5
Diet control: 29
GDM 58.7 ± 15.5;
control 36.9 ± 5.8
Third trimester
Ballesteros et al. [31]80/132GDM 31.88 ± 5.19;
control 31.33 ± 4.86
GDM 25.56 ± 4.94;
control 24.83 ± 5.13
Insulin therapy: 29
Diet control: 51
GDM 10.03 (7.01–15.12);
control 7.73 (5.83–13.28)
GDM 27.51 ± 1.41 w;
control 27.46 ± 1.40 w
Cortelazzi et al. [32]18/33GDM 34 ± 4.5;
control 29 ± 5.2
GDM 24.7 ± 2.1;
control 21.8 ± 1.2
Insulin therapy: 10
Diet control: 8
NP Between 37 and 41 w
Gao et al. [14]22/20GDM 30.97 ± 3.64;
control 28.80 ± 2.62
GDM 23.92 ± 3.51;
control 21.83 ± 2.33
Insulin therapy: yes, but not allNPGDM 29.28 ± 2.79 w;
control 28.00 ± 3.09 w
Georgiou et al. [22]14/14GDM 33.8 ± 5.0;
control 32.6 ± 3.4
GDM 28.2 ± 8.4;
control 24.7 ± 5.1
Insulin therapy: 6
Diet control: 8
GDM 14.3 ± 8.3;
control 8.9 ± 3.7
At 28 w
Horosz et al. [23]86/48GDM 31.8 ± 4.3;
control 30.7 ± 3.5
GDM 28.39 ± 5.32;
control 25.40 ± 2.72
Insulin therapy: yes, but not allGDM 9.77 ± 4.94;
control 8.10 ± 3.32
Between 27 and 32 w
Kinalski et al. [16]80/30GDM 29.0 ± 4.9;
control 28.2 ± 6.0
GDM 27.11 ± 4.58;
control 25.61 ± 3.41
Insulin therapy: no
Diet control: yes
GDM 11.03 ± 12.18;
control 5.46 ± 2.02
Third trimester
Kleiblova et al. [25]10/13GDM 34.6 ± 2.5;
control 33.1 ± 1.3
GDM 30.1 ± 2.3;
control 22.7 ± 0.9
Insulin therapy: allGDM 144.8 ± 64.56;
control 23.4 ± 1.96
GDM 268.9 ± 4.2 d;
control 276.9 ± 1.6 d
McLachlan et al. [17]19/19GDM 33 ± 1;
control 33 ± 1
GDM 31.5 ± 1.3;
control 31.6 ± 1.3
Insulin therapy: 5
Diet control: 14
NPThird trimester
Ranheim et al. [29]22/29NPGDM 31.4 ± 1;
control 28.3 ± 0.6
Insulin therapy: 30%
Diet control: 70%
GDM 389 ± 84;
control 75 ± 6
GDM 38.1 ± 0.3 w;
control 38.5 ± 0.3 w
Saucedo et al. [18]60/60GDM 31.9 ± 5.6;
control 24.8 ± 6.4
GDM 30.2 ± 4.9;
control 28.4 ± 7.3
Insulin therapy: yes, but not allGDM 61.1 ± 40.3;
control 50.7 ± 33.3
At 30 w
Soheilykhah et al. [33]30/31MatchedMatchedNPGDM 148.52 ± 258.30;
control 84.67 ± 35.16
At 28 w
Thyfault et al./A1 [34]11/27GDM 29.9 ± 1.8;
control 26.1 ± 1.1
GDM 35.1 ± 2.3;
control 33.4 ± 1.5
NPGDM 11.5 ± 2.1;
control 15.9 ± 3.3
GDM 39.5 ± 0.2 w;
control 39.2 ± 0.3 w
Thyfault et al./A2 [34]11/27GDM 30.7 ± 1.7;
control 26.1 ± 1.1
GDM 39.9 ± 2.5;
control 33.4 ± 1.5
NPGDM 28.7 ± 6.9;
control 15.9 ± 3.3
GDM 39.1 ± 0.4 w;
control 39.2 ± 0.3 w
Thyfault et al./B [34]9/27GDM 29.1 ± 1.7;
control 26.1 ± 1.1
GDM 39.6 ± 3.0;
control 33.4 ± 1.5
NPGDM 65.5 ± 31.8;
control 15.9 ± 3.3
GDM 38.0 ± 0.6 w;
control 39.2 ± 0.3 w
Tsai et al. [35]34/219GDM 32.4 ± 3.9;
control 30.9 ± 4.1
GDM 27.0 ± 3.4;
control 25.4 ± 2.9
Insulin therapy: no
Diet control: all
GDM 121.0 ± 45.3;
control 89.2 ± 36.3
GDM 27.0 ± 3.4 w;
control 25.4 ± 2.9 w
Worda et al. [36]20/21 GDM 34.3 ± 4.5;
control 29.4 ± 6.2
GDM 25.6 ± 4.6;
control 24.4 ± 4.6
Insulin therapy: allNPGDM 32.1 ± 2.5 w;
control 32.2 ± 4.1 w

BMI, body mass index; TNF-, tumor necrosis factor-alpha; w, weeks; NP, not provided; data are presented as mean + standard error of the mean or (%).