The effect of circulating adiponectin levels on incident gestational diabetes mellitus: systematic review and meta‑analysis

Shen Gao; Shaofei Su; Enjie Zhang; Yue Zhang; Jianhui Liu; Shuanghua Xie; Wentao Yue; Ruixia Liu; Chenghong Yin

doi:10.1080/07853890.2023.2224046

The effect of circulating adiponectin levels on incident gestational diabetes mellitus: systematic review and meta‑analysis

Ann Med. 2023 Dec;55(1):2224046. doi: 10.1080/07853890.2023.2224046.

Authors

Shen Gao¹, Shaofei Su¹, Enjie Zhang¹, Yue Zhang², Jianhui Liu¹, Shuanghua Xie¹, Wentao Yue², Ruixia Liu¹, Chenghong Yin¹

Affiliations

¹ Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China.
² Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China.

Abstract

Background: To quantitatively synthesize evidence from prospective observational studies regarding the mean levels of circulating adiponectin in patients with gestational diabetes mellitus (GDM) and the association between adiponectin levels and GDM risk.

Methods: PubMed, EMBASE and Web of Science were searched from their inception until November 8th, 2022, for nested case-control studies and cohort studies. Random-effect models were applied to the synthesized effect sizes. The difference in circulating adiponectin levels between the GDM and control groups was measured using the pooled standardized mean difference (SMD) and 95% confidence interval (CI). The relationship between circulating adiponectin levels and GDM risk was examined using the combined odds ratio (OR) and 95% CI. Subgroup analyses were performed according to the study continent, GDM risk in the study population, study design, gestational weeks of circulating adiponectin detection, GDM diagnostic criteria, and study quality. Sensitivity and cumulative analyses were performed to evaluate the stability of the meta-analysis. Publication bias was assessed by funnel plots and Egger's test.

Results: The 28 studies included 13 cohort studies and 15 nested case-control studies, containing 12,256 pregnant women in total. The mean adiponectin level in GDM patients was significantly lower than in controls (SMD = -1.514, 95% CI = -2.400 to -0.628, p = .001, I² = 99%). The risk of GDM was significantly decreased among pregnant women with increasing levels of circulating adiponectin (OR = 0.368, 95% CI = 0.271-0.500, p < .001, I²=83%). There were no significant differences between the subgroups.

Conclusions: Our findings indicate that increasing circulating adiponectin levels were inversely associated with the risk of GDM. Given the inherent heterogeneity and publication bias of the included studies, further well-designed large-scale prospective cohort or intervention studies are needed to confirm our finding.

Keywords: Adiponectin; gestational diabetes mellitus; meta-analysis; systematic review.

Plain language summary

Increasing circulating adiponectin levels in the first to the second trimester could decrease the risk of incident GDM.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Adiponectin*
Case-Control Studies
Diabetes, Gestational* / diagnosis
Diabetes, Gestational* / epidemiology
Female
Humans
Observational Studies as Topic
Odds Ratio
Pregnancy
Prospective Studies

Substances

Adiponectin

Grants and funding

This work was supported by the National Key Research and Development Program of China 2016YFC1000101, Beijing Municipal Administration of Hospitals Incubating Program (PX2023053) and Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support (202130).