In women with type 1 diabetes, circulating adipokines represent a potential biomarker for predicting preeclampsia risk in the first trimester of pregnancy, according to findings from a prospective study published in Diabetologia.
In this study, investigators obtained measurements of plasma adipokines specifically associated with insulin resistance to determine associative risks for preeclampsia. The circulating adipokines measured in this study included leptin, adiponectin fatty acid binding protein 4 (FABP4), resistin, and retinol binding protein 4.
Women with preeclampsia (n=23), women who were normotensive (n=24), and women who were healthy, normotensive, and did not have diabetes (n=19) were included in this study.
Leptin as well as the ratio of leptin to total or high-molecular weight (HMW) adiponectin increased in all arms. Additionally, FABP4 concentration, the ratio of FABP4 to total or HMW adiponectin, and resistin levels also increased across the study groups. Among women with type 1 diabetes and preeclampsia, leptin, the ratio of leptin to total or HMW adiponectin, and the ratio of FABP4 to total or HMW adiponectin were significantly higher compared with measures in women with type 1 diabetes without subsequent preeclampsia (P <.05). Conversely, total adiponectin was decreased in patients with vs without preeclampsia (P <.05). These findings persisted throughout the study period.
The small sample size of this cohort relative to the number of biomarkers represents the primary limitation of this study. Additionally, the participants’ freedom from hypertension and microalbuminuria prevents generalization of the findings to the broader population of people with type 1 diabetes.
Contrary to current models to predict risk for preeclampsia in pregnant women with type 1 diabetes, the investigators suggest that the identification of circulating adipokines, “may be more convenient and widely applicable” in clinical practice.