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Is resistin a mediator of gestational diabetes? Previous abstracts in this series have commented on the roles of leptin and adiponectin in the regulation of appetite and glucose homeostasis. To this short list one should now add resistin, a 114-amino acid polypeptide which also emanates from fat and has been proposed as a prime link between obesity and insulin resistance. In animal experiments resistin infusion leads to hyperglycemia, and infusion of resistin antibodies lowers glucose levels. The placenta appears to be a source of resistin, and plasma levels are fourfold higher than normal during pregnancy. While studies have not yet confirmed a rapid fall-off in resistin levels immediately after delivery (which would be expected because true gestational diabetes usually corrects soon after delivery) it would appear that this 'new' hormone plays a role in the genesis of gestational diabetes together with the known old ones (HPL, HPGH, progesterone, cortisol and prolactin). Leptin and TNF-alpha have also been shown to play a part. Read more: Lancet 2003;362:1777-8 Diabetes 2002;51:2207-13 Acta Obstets Gynaecol Scand 2003;82:432-8 Nature 2001;409:307-12 J Clin Endocrin Metab 2003;88:1394-7 |