Serum C-reactive protein related to obesity in pregnant women

University of Toronto-October 15, 2003

"Acute-phase biomarkers such as C-reactive protein (CRP) and IL-6 have emerged as predictors of incident type 2 diabetes mellitus, implicating chronic subclinical inflammation as a factor in the pathophysiology of diabetes. Gestational diabetes (GDM) identifies a population of women at high risk of subsequent type 2 diabetes mellitus, representing an early stage in the natural history of the disease. In this context, we performed a cross-sectional study to determine whether markers of subclinical inflammation are elevated in patients with GDM," scientists writing in the Journal of Clinical Endocrinology and Metabolism report.

"We studied 180 healthy pregnant women undergoing oral glucose tolerance testing in the late second or early third trimester," said Ravi Retnakaran and collaborators at the University of Toronto and Mount Sinai Hospital in Canada. "Based on oral glucose tolerance testing and prepregnancy body mass index (BMI), participants were stratified into four groups: normal glucose tolerance (NGT) lean (BMI, <25 kg/m2) (n=65); NGT overweight (n=28); impaired glucose tolerance (n=39); and GDM (n=48). Median CRP level was highest in overweight NGT subjects (8.8 mg/L), followed by GDM (5.5 mg/L), impaired glucose tolerance (4.4 mg/L), and lean NGT (4.4 mg/L) (overall p=0.0297)."

"CRP was significantly correlated with prepregnancy BMI (r=0.38, p<0.0001), followed by fasting insulin (r=0.27, p=0.0002) and fasting blood glucose (r=0.18, p=0.016)," reported the investigators. "In multivariate linear regression analysis, prepregnancy BMI emerged as the most important determinant of CRP concentration, whereas glycemic tolerance status was not a significant factor. Furthermore, the observed stepwise increase in CRP per tertile of prepregnancy BMI was not significantly attenuated by glycemic tolerance status or factors known to be associated with GDM."

"In summary, we demonstrate that maternal serum levels of CRP are not related to GDM but rather correlate significantly with prepregnancy obesity," concluded Retnakaran and colleagues. "An independent contribution of CRP to risk of GDM could not be confirmed. These data suggest a model in which obesity mediates a systemic inflammatory response, with possible downstream metabolic sequelae, including insulin resistance and glucose dysregulation."

Retnakaran and associates published their study in the Journal of Clinical Endocrinology and Metabolism (C-reactive protein and gestational diabetes: The central role of maternal obesity. J Clin Endocrinol Metab, 2003;88(8):3507-3512).

Additional information can be obtained by contacting Bernard Zinman, Mount Sinai Hospital, Leadership Sinai Center Diabetes, 60 Murray Street, Suite 5024, Toronto, ON M5G 1X5, Canada.

The information in this article comes under the major subject areas of Gestational Diabetes, C-Reactive Protein, Endocrinology, Glucose Tolerance, Insulin Resistance, Obesity and Diabetes, Obstetrics, and Women's Health. This article was prepared by Biotech Week editors from staff and other reports.

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