Association of gestational serum adiponectin with postpartum glycaemic outcomes in GDM: a prospective cohort study

This study investigated the association between gestational serum adiponectin (APN) levels and postpartum glycaemic outcomes in women with gestational diabetes mellitus (GDM).

A total of 96 GDM patients were enrolled. Baseline demographic and biochemical data were collected. Serum APN levels were measured longitudinally across three gestational stages and postpartum using an enzyme-linked immunosorbent assay. Based on 1-year follow-up data, patients were classified into favourable (normal glucose metabolism) and unfavourable (prediabetes or type 2 diabetes mellitus [T2DM]) outcome groups. Statistical analyses included t-tests, non-parametric tests, Cox proportional hazards models, and Kaplan-Meier survival curves to assess the associations between APN levels and outcomes.

At 1-year follow-up, 54.17% had favourable outcomes with higher APN levels, while 45.83% had unfavourable outcomes characterised by older age, higher BMI, and a higher prevalence of family history. T2DM patients had lower APN than those with prediabetes. Cox regression identified postpartum APN as an independent protective factor (Hazard Ratio [HR] = 0.720, 95% confidence interval [CI]: 0.60-0.85, P < 0.001), with each 1-μg/mL increase reducing risk by 27%. Significant risk factors included age (HR = 1.10, 95% CI: 1.01-1.20), pre-pregnancy BMI (HR = 2.06, 95% CI: 1.03-4.14), family history (HR = 2.58, 95% CI: 1.22-5.46), fasting glucose (HR = 1.41, 95% CI: 1.17-1.70), and 1-hour OGTT glucose (HR = 1.20, 95% CI: 1.02-1.40). The low-APN group showed significantly higher cumulative incidence of metabolic dysfunction.

Gestational APN levels are strongly associated with postpartum metabolic outcomes in GDM. Low APN is an independent risk factor for adverse outcomes, and its dynamic changes reflect metabolic recovery capacity.