Circulating apelin levels are associated with cardiometabolic risk factors in women with previous gestational diabetes

Women with previous gestational diabetes mellitus (pGDM) are at high risk for type 2 diabetes and cardiovascular disorders. In this study, we aimed to compare plasma apelin levels between women with and without pGDM, and to investigate the possible association of apelin with cardiometabolic risk factors. Among 252 consecutive Caucasian women with GDM being included in a prospective postpartum follow-up protocol, 141 women eligible for the study protocol were enrolled. Control group consisted of 49 age- and body mass index-matched healthy women without pGDM. Circulating apelin, IL-6 and plasminogen activator inhibitor levels, and carotid intima media thickness (IMT) were measured. To evaluate carbohydrate intolerance, 75-g oral glucose tolerance test was performed. Fasting insulin and lipids were measured, and homeostasis model assessment index was calculated. Plasma apelin levels were reduced in women with pGDM (p < 0.001). In multiple regression analysis, apelin was negatively associated with fasting (r (2) 0.090, beta -0.273, p = 0.001) and post-load glucose (r (2) 0.061, beta -0.187, p = 0.022), serum IL-6 (r (2) 0.082, beta -0.234, p = 0.002), and carotid IMT (r (2) 0.057, beta -0.168, p = 0.033). Our results suggested that suppressed apelin levels were associated with increased cardiovascular risk in women with pGDM.