Maternal Serum Visfatin, Adiponectin, Human Placental Lactogen, and Insulin as Potential Biomarkers of Fetal Macrosomia in Gestational Diabetes Mellitus

Abstract

Gestational diabetes mellitus (GDM) is linked to metabolic and endocrine changes that may contribute to the development of fetal macrosomia and excessive fetal growth. The present study aimed to evaluate some maternal metabolic biomarkers; visfatin, adiponectin, human placental lactogen (HPL), and insulin concentrations, as well as their correlation and diagnostic performance, in pregnancies with fetal macrosomia induced by gestational diabetes.

    In the third trimester (28–36 weeks of gestation), a case-control study was conducted on 90 pregnant women. The study included 60 women with GDM who were carrying a macrosomic fetus and 30 healthy pregnant women who maintained normal fetal growth. enzyme-linked immunosorbent assay (ELISA) was employed to determine the concentrations of visfatin, adiponectin, HPL, and insulin in the maternal serum. Pearson's correlation coefficient, receiver operating characteristic (ROC) curve analysis, and independent-samples t-test were implemented in the statistical analyses. Maternal serum visfatin (3.136 ± 0.33 vs. 1.842 ± 0.27 ng/mL), HPL (475.61 ± 29.55 vs. 338.06 ± 19.21 ng/mL), and insulin (8.28 ± 0.22 vs. 8.12 ± 0.15 mU/L) concentrations were significantly higher in pregnancies with fetal macrosomia than in healthy controls, whereas adiponectin concentrations were significantly lower (9.03 ± 0.17 vs. 13.62 ± 0.60 ng/mL) (P<0.01). In the macrosomia group, correlation analysis revealed substantial positive correlations between adiponectin and HPL, estimated fetal weight, and visfatin. The diagnostic performance of adiponectin was the highest (AUC = 0.744), followed by visfatin (AUC = 0.681), according to the ROC analysis. HPL exhibited limited diagnostic performance (AUC = 0.508). These findings suggest that adiponectin may be a promising biomarker for identifying pregnancies at increased risk of fetal macrosomia, and that maternal adipokines and placental hormones are closely associated with the metabolic disturbances underlying fetal macrosomia