Can Adiponectin Predict Hypertensive Disorder in Pregnancy?

Main Article Content

Somsri Pitukkijronnakorn
Panyu Panburana
Kanokwan Wetsatada
Umaporn Udomsubpayakul
Sawaek Weerakiet


Objective: To determine whether adiponectin can predict hypertensive disorder in pregnancy (HDP).

Methods: All women with singleton pregnancy and who were at risk of gestational diabetes mellitus (GDM) were studied. They underwent a 50 gram glucose challenge test (GCT) and a blood sample test for adiponectin between 21 and 27 weeks gestation. Subsequently, between 24 and 28 weeks gestation the women underwent a 100 gram oral glucose tolerance test (OGTT). The pregnancy and perinatal outcomes in all women were observed and analyzed.

Results: There were 359 women enrolled in this study. Twenty-two case of HDP (6.1%) and 60 women with GDM (16.7%) were diagnosed. There were no significant difference in age, pre-pregnant BMI, sampling day BMI, weight gain on sampling day and total weight gain during pregnancy in both groups. Serum adiponectin was not significantly lower in HDP than non-HDP women (P = NS). There was a relationship between pre-pregnant BMI and total adiponectin levels in HDP (P = 0.0143). The area under the receiver-operator characteristic curve was 0.5853. In order to predict HDP, an arbitrarily cut-off value of adiponectin was determined. With the adiponectin cut-off value < 4.4 mg/ml, the sensitivity, specificity, PPV and NPV were 4.55%, 90.50%, 4.76% and 93.14% respectively. At cut-off value, only 1 out of 22 cases of HDP could be identified.

Conclusion: The levels of adiponectin in women with HDP were not significantly different from those without HDP and could not predict HDP.

Article Details

How to Cite
Pitukkijronnakorn, S., Panburana, P., Wetsatada, K., Udomsubpayakul, U., & Weerakiet, S. (2010). Can Adiponectin Predict Hypertensive Disorder in Pregnancy?. Ramathibodi Medical Journal, 33(2), 49–56. Retrieved from
Original Articles


Cunningham FG, ‎ Leveno KJ, ‎ Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. Williams Obstetrics. 22nd ed. New York, NY: McGraw-Hill; 2005:761-808.

Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22. doi:10.1067/mob.2000.107928.

Caruso A, Ferrazzani S, De Carolis S, Lucchese A, Lanzone A, De Santis L. et al. Gestational hypertension but not pre-eclampsia is associated with insulin resistance syndrome characteristics. Hum Reprod. 1999;14(1):219-23.

Kaaja R, Tikkanen MJ, Viinikka L, Ylikorkala O. Serum lipoproteins, insulin, and urinary prostanoid metabolites in normal and hypertensive pregnant women. Obstet Gynecol. 1995 ;85(3):353-6. doi:10.1016/0029-7844(94)00380-V.

Martinez Abundis E, Gonzalez Ortiz M, Quiñones Galvan A, Ferrannini E. Hyperinsulinemia in glucose-tolerant women with preeclampsia. A controlled study. Am J Hypertens. 1996;9(6):610-4.

Kirwan JP, Hauguel-De Mouzon S, Lepercq J, Challier JC, Huston-Presley L, Friedman JE. TNF-alpha is a predictor of insulin resistance in human pregnancy. Diabetes. 2002;51(7):2207-13. doi:10.2337/diabetes.51.7.2207.

Ehrenberg HM, Huston-Presley L, Catalano PM. The influence of obesity and gestational diabetes mellitus on accretion and the distribution of adipose tissue in pregnancy. Am J Obstet Gynecol. 2003;189(4):944-8. doi:10.1067/S0002-9378(03)00761-0.

Haugen F, Ranheim T, Harsem NK, Lips E, Staff AC, Drevon CA. Increased plasma levels of adipokines in preeclampsia: relationship to placenta and adipose tissue gene expression. Am J Physiol Endocrinol Metab. 2006;290(2):E326-33. doi:10.1152/ajpendo.00020.2005.

Chandran M, Phillips SA, Ciaraldi T, Henry RR. Adiponectin: more than just another fat cell hormone? Diabetes Care. 2003;26(8):2442-50. doi:10.2337/diacare.26.8.2442.

Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, et al. The hormone resistin links obesity to diabetes. Nature. 2001;409(6818):307-12. doi:10.1038/35053000.

Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001;86(5):1930-5. doi:10.1210/jcem.86.5.7463.

Mazaki-Tovi S, Kanety H, Pariente C, Hemi R, Wiser A, Schiff E, et al. Maternal serum adiponectin levels during human pregnancy. J Perinatol. 2007;27(2):77-81. doi:10.1038/

Fuglsang J, Skjaerbaek C, Frystyk J, Flyvbjerg A, Ovesen P. A longitudinal study of serum adiponectin during normal pregnancy. BJOG. 2006;113(1):110-3. doi:10.1111/j.1471-0528.2005.00792.x.

Naruse K, Yamasaki M, Umekage H, Sado T, Sakamoto Y, Morikawa H. Peripheral blood concentrations of adiponectin, an adipocyte-specific plasma protein, in normal pregnancy and preeclampsia. J Reprod Immunol. 2005;65(1):65-75. doi:10.1016/j.jri.2004.09.004.

Ramsay JE, Jamieson N, Greer IA, Sattar N. Paradoxical elevation in adiponectin concentrations in women with preeclampsia. Hypertension. 2003;42(5):891-4. . doi:10.1161/01.HYP.0000095981.92542.F6.

Cortelazzi D, Corbetta S, Ronzoni S, Pelle F, Marconi A, Cozzi V, et al. Maternal and foetal resistin and adiponectin concentrations in normal and complicated pregnancies. Clin Endocrinol (Oxf). 2007;66(3):447-53. doi:10.1111/j.1365-2265.2007.02761.x.

Mazaki-Tovi S, Kanety H, Sivan E. Adiponectin and human pregnancy. Curr Diab Rep. 2005;5(4):278-81.

Ichida K, Moriyama T, Morita H, Kondo T, Yoshida S, Ohara N, Maruo T. Plasma adiponectin concentrations and placental adiponectin expression in pre-eclamptic women. Gynecol Endocrinol. 2007;23(4):238-43. doi:10.1080/09513590701297740.

American College of Obstetricians and Gynecologists (ACOG). Gestational Diabetes. ACOG Practice Bulletin No. 30. Washington, DC: American College of Obstetricians and Gynecologists (ACOG); 2001:30-5.

Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2000;23 Suppl 1:S4-19.

Seely EW, Solomon CG. Insulin resistance and its potential role in pregnancy-induced hypertension. J Clin Endocrinol Metab. 2003;88(6):2393-8. doi:10.1210/jc.2003-030241.

Solomon CG, Seely EW. Brief review: hypertension in pregnancy: a manifestation of the insulin resistance syndrome? Hypertension. 2001;37(2):232-9.

Cseh K, Baranyi E, Melczer Z, Kaszás E, Palik E, Winkler G. Plasma adiponectin and pregnancy-induced insulin resistance. Diabetes Care. 2004;27(1):274-5. doi:10.2337/diacare.27.1.274.

Ranheim T, Haugen F, Staff AC, Braekke K, Harsem NK, Drevon CA. Adiponectin is reduced in gestational diabetes mellitus in normal weight women. Acta Obstet Gynecol Scand. 2004 ;83(4):341-7.

Shinohara K, Wakatsuki A, Watanabe K, Ikenoue N, Fukaya T. Plasma adiponectin concentrations in women with preeclampsia. Hypertension. 2004;43(4):e17;author reply e17. doi:10.1161/01.HYP.0000118058.72512.08.

O'Sullivan AJ, Kriketos AD, Martin A, Brown MA. Serum adiponectin levels in normal and hypertensive pregnancy. Hypertens Pregnancy. 2006;25(3):193-203. doi:10.1080/10641950600912976.

Waki H, Yamauchi T, Kamon J, Ito Y, Uchida S, Kita S, et al. Impaired multimerization of human adiponectin mutants associated with diabetes. Molecular structure and multimer formation of adiponectin. J Biol Chem. 2003 Oct 10;278(41):40352-63. doi:10.1074/jbc.M300365200.

Fisher FM, Trujillo ME, Hanif W, Barnett AH, McTernan PG, Scherer PE, et al. Serum high molecular weight complex of adiponectin correlates better with glucose tolerance than total serum adiponectin in Indo-Asian males. Diabetologia. 2005;48(6):1084-7. doi:10.1007/s00125-005-1758-7.

Catalano PM, Hoegh M, Minium J, Huston-Presley L, Bernard S, Kalhan S, et al. Adiponectin in human pregnancy: implications for regulation of glucose and lipid metabolism. Diabetologia. 2006;49(7):1677-85. doi:10.1007/s00125-006-0264-x.

Retnakaran R, Hanley AJ, Raif N, Connelly PW, Sermer M, Zinman B. Hypoadiponectinaemia in South Asian women during pregnancy: evidence of ethnic variation in adiponectin concentration. Diabet Med. 2004;21(4):388-92. doi:10.1111/j.1464-5491.2004.1151.x.

O'Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14(3):368-74. doi:10.1097/01.EDE.0000059921.71494.D1.

Hendler I, Blackwell SC, Mehta SH, Whitty JE, Russell E, Sorokin Y, et al. The levels of leptin, adiponectin, and resistin in normal weight, overweight, and obese pregnant women with and without preeclampsia. Am J Obstet Gynecol. 2005;193(3 Pt 2):979-83. doi:10.1016/j.ajog.2005.06.041.