TY - JOUR
T1 - Dysregulation of maternal serum adiponectin in preterm labor
AU - Mazaki-Tovi, Shali
AU - Romero, Roberto
AU - Vaisbuch, Edi
AU - Erez, Offer
AU - Mittal, Pooja
AU - Chaiworapongsa, Tinnakorn
AU - Kim, Sun Kwon
AU - Pacora, Percy
AU - Yeo, Lami
AU - Gotsch, Francesca
AU - Dong, Zhong
AU - Nhan-Chang, Chia Ling
AU - Jodicke, Cristiano
AU - Yoon, Bo Hyun
AU - Hassan, Sonia S.
AU - Kusanovic, Juan Pedro
N1 - Funding Information:
This research was supported (in part) by the Perinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS.
PY - 2009/11/9
Y1 - 2009/11/9
N2 - Objective. Intra-amniotic and systemic infectioninflammation have been causally linked to preterm parturition and fetal injury. An emerging theme is that adipose tissue can orchestrate a metabolic response to insults, but also an inflammatory response via the production of adipocytokines, and that these two phenomenons are interrelated. Adiponectin, an insulin-sensitising, anti-inflammatory adipocytokine, circulates in multimeric complexes including low-molecular weight LMW trimers, medium-molecular weight MMW hexamers and high-molecular weight HMW isoforms. Each of these complexes can exert differential biological effects. The aim of this study was to determine whether spontaneous preterm labor PTL with intact membranes and intra-amniotic infectioninflammation IAI is associated with changes in maternal serum circulating adiponectin multimers. Study design. This cross-sectional study included patients in the following groups: 1 normal pregnant women n 158; 2 patients with an episode of preterm labor and intact membranes without IAI who delivered at term n 41; 3 preterm labor without IAI who delivered preterm n 27; and 4 preterm labor with IAI who delivered preterm n 36. Serum adiponectin multimers total, HMW, MMW and LMW concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results. 1 Preterm labor leading to preterm delivery or an episode of preterm labor that does not lead to preterm delivery was associated with a lower median maternal serum concentration of total and HMW adiponectin, a lower median HMWtotal adiponectin ratio and a higher median LMWtotal adiponectin ratio than normal pregnancy; 2 among patients with preterm labor, those with IAI had the lowest median concentration of total and HMW adiponectin, as well as the lowest median HMWtotal adiponectin ratio; 3 the changes in maternal adiponectin and adiponectin multimers remained significant after adjusting for confounding factors such as maternal age, BMI, gestational age at sampling and parity. Conclusion. 1 Preterm labor is characterised by a change in the profile of adiponectin multimers concentrations and their relative isoforms. These changes were observed in patients with an episode of preterm labor not leading to preterm delivery, in patients with intra-amniotic inflammation, or in those without evidence of intra-amniotic inflammation. 2 The changes in adiponectin multimer concentrations reported in preterm labor are different from those previously reported in spontaneous labor at term, suggesting that there is a fundamental difference between preterm labor and labor at term. 3 The findings reported herein provide the first evidence for the participation of adiponectin multimer in preterm parturition. We propose that adiponectins and adipokines in general provide a mechanism to organise the metabolic demands generated by the process of preterm parturition regardless of the nature of the insult intra-amniotic inflammation or not.
AB - Objective. Intra-amniotic and systemic infectioninflammation have been causally linked to preterm parturition and fetal injury. An emerging theme is that adipose tissue can orchestrate a metabolic response to insults, but also an inflammatory response via the production of adipocytokines, and that these two phenomenons are interrelated. Adiponectin, an insulin-sensitising, anti-inflammatory adipocytokine, circulates in multimeric complexes including low-molecular weight LMW trimers, medium-molecular weight MMW hexamers and high-molecular weight HMW isoforms. Each of these complexes can exert differential biological effects. The aim of this study was to determine whether spontaneous preterm labor PTL with intact membranes and intra-amniotic infectioninflammation IAI is associated with changes in maternal serum circulating adiponectin multimers. Study design. This cross-sectional study included patients in the following groups: 1 normal pregnant women n 158; 2 patients with an episode of preterm labor and intact membranes without IAI who delivered at term n 41; 3 preterm labor without IAI who delivered preterm n 27; and 4 preterm labor with IAI who delivered preterm n 36. Serum adiponectin multimers total, HMW, MMW and LMW concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results. 1 Preterm labor leading to preterm delivery or an episode of preterm labor that does not lead to preterm delivery was associated with a lower median maternal serum concentration of total and HMW adiponectin, a lower median HMWtotal adiponectin ratio and a higher median LMWtotal adiponectin ratio than normal pregnancy; 2 among patients with preterm labor, those with IAI had the lowest median concentration of total and HMW adiponectin, as well as the lowest median HMWtotal adiponectin ratio; 3 the changes in maternal adiponectin and adiponectin multimers remained significant after adjusting for confounding factors such as maternal age, BMI, gestational age at sampling and parity. Conclusion. 1 Preterm labor is characterised by a change in the profile of adiponectin multimers concentrations and their relative isoforms. These changes were observed in patients with an episode of preterm labor not leading to preterm delivery, in patients with intra-amniotic inflammation, or in those without evidence of intra-amniotic inflammation. 2 The changes in adiponectin multimer concentrations reported in preterm labor are different from those previously reported in spontaneous labor at term, suggesting that there is a fundamental difference between preterm labor and labor at term. 3 The findings reported herein provide the first evidence for the participation of adiponectin multimer in preterm parturition. We propose that adiponectins and adipokines in general provide a mechanism to organise the metabolic demands generated by the process of preterm parturition regardless of the nature of the insult intra-amniotic inflammation or not.
KW - Adipokines
KW - Adiponectin
KW - Chorioamnionitis
KW - Energy expenditure
KW - Energy requirements
KW - High molecular weight
KW - Inflammation
KW - Intra-amniotic infection
KW - Low molecular weight
KW - Medium molecular weight
KW - Metabolism
KW - Pregnancy
KW - Preterm birth
KW - Preterm delivery
KW - Preterm labor
UR - http://www.scopus.com/inward/record.url?scp=70350662928&partnerID=8YFLogxK
U2 - 10.1080/14767050902994655
DO - 10.1080/14767050902994655
M3 - Article
C2 - 19579094
AN - SCOPUS:70350662928
SN - 1476-7058
VL - 22
SP - 887
EP - 904
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 10
ER -