Defective Visceral Adipose Tissue Adaptation in Gestational Diabetes Mellitus
Open accessAbstract
Context: Gestational diabetes mellitus (GDM) is a complex obstetric condition affecting localized glucose metabolism, resulting in systemic metabolic dysfunction. Objective: This cross-sectional study aimed to explore visceral adipose tissue (VAT) as an integral contributor to GDM, focusing on elucidating the specific contribution of obesity and GDM pathology to maternal outcomes. Methods: Fifty-six nulliparous pregnant women were recruited, including normal glucose tolerant (NGT) (n = 30) and GDM (n = 26) participants. Participants were subgrouped as nonobese (BMI <30 kg/m2) or obese (BMI ≥30 kg/m2). Metabolic markers in circulation, VAT, and placenta were determined. Morphological analysis of VAT and immunoblotting of the insulin signaling cascade were performed. Results: GDM participants demonstrated hyperinsulinemia and elevated homeostatic model assessment for insulin resistance (HOMA-IR) scores relative to NGT participants. The GDM-obese subgroup had significant VAT adipocyte hypoplasia relative to NGT-nonobese tissue. GDM-obese VAT had significantly lower insulin receptor substrate (IRS)-2 expression, with elevated ser312 phosphorylation of IRS-1, relative to NGT-nonobese. GDM-obese participants had significantly elevated circulating leptin levels and placental adipsin secretion, while GDM-nonobese participants had elevated circulating adipsin levels with reduced placental adiponectin secretion. Conclusion: These findings suggest that GDM-obese pregnancy is specifically characterized by inadequate VAT remodeling and dysfunctional molecular signaling, which contribute to insulin resistance and hinder metabolic health.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Women with GDM and a BMI ≥ 30 kg/m2 have significant adipocyte hypoplasia in omental visceral adipose tissue depots compared to women with GDM and a BMI < 30 kg/m2.
“A cross-sectional study by McElwain CJ et al. [112] demonstrated that women with GDM and a BMI ≥ 30 kg/m2 had significant adipocyte hypoplasia in omental visceral adipose tissue depots compared to women with GDM and a BMI ˂ 30 kg/m2.”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [112]
The Results section reports significant omental VAT adipocyte hypoplasia in women with GDM and obesity, using the stated BMI categories. However, the significant comparison is with women who were nonobese and had normal glucose tolerance, not with nonobese women with GDM as the citing sentence claims. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredVisceral adipocyte tissue from women with GDM and obesity shows impaired intracellular insulin signalling pathways, including reduced expression of insulin receptor substrate 2.
“Visceral adipocyte tissue from women with GDM and obesity also showed impaired intracellular insulin signalling pathways, including reduced expression of insulin receptor substrate 2, which is essential for glucose metabolism.”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [112]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Monocyte chemoattractant protein 1 in obesity and insulin resistance
Sartipy, P., & Loskutoff, D. J. (2003) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1133870100 · Cited by 1,201 · see citing works
Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes
Barbour, L. A., McCurdy, C. E., Hernandez, T. L., Kirwan, J. P., Catalano, P. M., & Friedman, J. E. (2007) · Diabetes Care · doi:10.2337/dc07-s202 · Cited by 811 · see citing works
Narrative Review: The Role of Leptin in Human Physiology: Emerging Clinical Applications
Kelesidis, T., Kelesidis, I., Chou, S. H.-H., & Mantzoros, C. S. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-152-2-201001190-00008 · Cited by 667 · see citing works
IGF-Binding Proteins: Why Do They Exist and Why Are There So Many?
Allard, J. B., & Duan, C. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00117 · Cited by 517 · see citing works
The Role of Placental Hormones in Mediating Maternal Adaptations to Support Pregnancy and Lactation
Napso, T., Yong, H. E. J., Lopez-Tello, J., & Sferruzzi-Perri, A. N. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.01091 · Cited by 470 · see citing works
Trying to understand gestational diabetes
Catalano, P. M. (2014) · Diabetic Medicine · doi:10.1111/dme.12381 · Cited by 456 · see citing works
Molecular interactions of the IGF system
Denley, A., Cosgrove, L. J., Booker, G. W., Wallace, J. C., & Forbes, B. E. (2005) · Cytokine & Growth Factor Reviews · doi:10.1016/j.cytogfr.2005.04.004 · Cited by 438 · see citing works
Santomauro, A. T., Boden, G., Silva, M. E., Rocha, D. M., Santos, R. F., Ursich, M. J., Strassmann, P. G., & Wajchenberg, B. L. (1999) · Diabetes · doi:10.2337/diabetes.48.9.1836 · Cited by 431 · see citing works
Frühbeck, G., Catalán, V., Rodrı́guez, A., & Gómez‐Ambrosi, J. (2017) · Adipocyte · doi:10.1080/21623945.2017.1402151 · Cited by 431 · see citing works
Adiponectin in insulin resistance: lessons from translational research
Ziemke, F., & Mantzoros, C. S. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28449c · Cited by 422 · see citing works
Adipsin Is an Adipokine that Improves β Cell Function in Diabetes
Lo, J. C., Ljubicic, S., Leibiger, B., Kern, M., Leibiger, I. B., Moede, T., Kelly, M. E., Bhowmick, D. C., Murano, I., Cohen, P., et al. (2014) · Cell · doi:10.1016/j.cell.2014.06.005 · Cited by 376 · see citing works
Adipose tissue fibrosis, hypertrophy, and hyperplasia: Correlations with diabetes in human obesity
Muir, L. A., Neeley, C. K., Meyer, K. A., Baker, N. A., Brosius, A. M., Washabaugh, A. R., Varban, O. A., Finks, J. F., Zamarron, B. F., Flesher, C. G., et al. (2016) · Obesity · doi:10.1002/oby.21377 · Cited by 367 · see citing works
Behboudi-Gandevani, S., Amiri, M., Bidhendi Yarandi, R., & Ramezani Tehrani, F. (2019) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-019-0406-1 · Cited by 321 · see citing works
Chen, J., Tan, B., Karteris, E., Zervou, S., Digby, J., Hillhouse, E. W., Vatish, M., & Randeva, H. S. (2006) · Diabetologia · doi:10.1007/s00125-006-0194-7 · Cited by 272 · see citing works
Lipid-Overloaded Enlarged Adipocytes Provoke Insulin Resistance Independent of Inflammation
Kim, J. I., Huh, J. Y., Sohn, J. H., Choe, S. S., Lee, Y. S., Lim, C. Y., Jo, A., Park, S. B., Han, W., & Kim, J. B. (2015) · Molecular and Cellular Biology · doi:10.1128/mcb.01321-14 · Cited by 259 · see citing works
Disparities in the risk of gestational diabetes by race-ethnicity and country of birth
Hedderson, M. M., Darbinian, J. A., & Ferrara, A. M. (2010) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2010.01140.x · Cited by 242 · see citing works
Saeedi, M., Cao, Y., Fadl, H., Gustafson, H., & Simmons, D. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108642 · Cited by 234 · see citing works
Catalano, P. M., Nizielski, S. E., Shao, J., Preston, L., Qiao, L., & Friedman, J. E. (2002) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00124.2001 · Cited by 218 · see citing works
Gestational Diabetes Mellitus in Europe: A Systematic Review and Meta-Analysis of Prevalence Studies
Paulo, M. S., Abdo, N. M., Bettencourt-Silva, R., & Al-Rifai, R. H. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.691033 · Cited by 181 · see citing works
Hammarstedt, A., Graham, T. E., & Kahn, B. B. (2012) · Diabetology & Metabolic Syndrome · doi:10.1186/1758-5996-4-42 · Cited by 120 · see citing works
Hormones and insulin resistance during pregnancy
Ryan, E. A. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14942-2 · Cited by 118 · see citing works
Liu, W. Y., Zhou, X., Li, Y., Zhang, S., Cai, X., Zhang, R., Gong, S., Han, X., & Ji, L. (2020) · Medicine · doi:10.1097/md.0000000000019052 · Cited by 105 · see citing works
Byun, D. W., Mohan, S., Yoo, M. H., Sexton, C., Baylink, D. J., & Qin, X. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.2.7223 · Cited by 92 · see citing works
Sorisky, A., Molgat, A. S. D., & Gagnon, A. (2013) · Advances in Nutrition · doi:10.3945/an.112.003020 · Cited by 73 · see citing works
Adipokines, an adipose tissue and placental product with biological functions during pregnancy
D’Ippolito, S., Tersigni, C., Scambia, G., & Simone, N. D. (2012) · BioFactors · doi:10.1002/biof.201 · Cited by 73 · see citing works
Byun, D. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.86.2.847 · Cited by 73 · see citing works
Adipose Tissue Function in Healthy Pregnancy, Gestational Diabetes Mellitus and Pre-Eclampsia
Trivett, C., Lees, Z. J., & Freeman, D. J. (2021) · European Journal of Clinical Nutrition · doi:10.1038/s41430-021-00948-9 · Cited by 65 · see citing works
A novel automated image analysis method for accurate adipocyte quantification
Osman, O. S., Selway, J. L., Kępczyńska, M. A., Stocker, C. J., O’Dowd, J. F., Cawthorne, M. A., Arch, J. R. S., Jassim, S., & Langlands, K. (2013) · Adipocyte · doi:10.4161/adip.24652 · Cited by 64 · see citing works
Human adipose tissue expansion in pregnancy is impaired in gestational diabetes mellitus
Rojas-Rodriguez, R., Lifshitz, L. M., Bellve, K. D., Min, S. Y., Pires, J., Leung, K., Boeras, C., Sert, A., Draper, J. T., Corvera, S., et al. (2015) · Diabetologia · doi:10.1007/s00125-015-3662-0 · Cited by 61 · see citing works
Suárez‐Cuenca, J. A., la Peña‐Sosa, G. D., la Vega-Moreno, K. D., Banderas-Lares, D. Z., Salamanca-García, M., Martínez-Hernández, J. E., Vera‐Gómez, E., Hernández‐Patricio, A., Zamora-Alemán, C. R., Domínguez-Pérez, G. A., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-81289-2 · Cited by 57 · see citing works
Barbour, L. A., McCurdy, C. E., Hernandez, T. L., & Friedman, J. E. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2116 · Cited by 47 · see citing works
Alharbi, K. K., Khan, I. A., Abotalib, Z. M., & Al-Hakeem, M. M. (2014) · BioMed Research International · doi:10.1155/2014/146495 · Cited by 44 · see citing works
Sivakumar, K., Bari, M. F., Adaikalakoteswari, A., Guller, S. M., Weickert, M. O., Randeva, H. S., Grammatopoulos, D. K., Bastie, C. C., & Vatish, M. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-4293 · Cited by 34 · see citing works
Groeneveld, M. P., Brierley, G. V., Rocha, N., Siddle, K., & Semple, R. K. (2016) · Scientific Reports · doi:10.1038/srep21105 · Cited by 25 · see citing works
Lekva, T., Lyle, R., Roland, M. C. P., Friis, C. M., Bianchi, D. W., Jaffe, I. Z., Norwitz, E. R., Bollerslev, J., Henriksen, T., & Ueland, T. (2016) · Scientific Reports · doi:10.1038/srep29715 · Cited by 24 · see citing works
Vejražková, D., Lischkova, O., Vaňková, M., Stanická, S., Vrbíková, J., LUKASOVA, P., Včelák, J., Vacínová, G., & Bendlová, B. (2017) · Physiological Research · doi:10.33549/physiolres.933366 · Cited by 24 · see citing works
Saucedo, R., Valencia‐Ortega, J., Moreno-González, L. E., Peña-Cano, M. I., Aranda-Martínez, A., García, Y., Díaz-Velázquez, M. F., & Hernández-Valencia, M. (2021) · Ginekologia Polska · doi:10.5603/gp.a2021.0083 · Cited by 18 · see citing works
Flagged first, then by citations
1 of the 38 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Gestational Diabetes Mellitus: Mechanisms Underlying Maternal and Fetal Complications
Lee, J., Lee, N. K., & Moon, J. H. (2025) · Endocrinology and Metabolism · doi:10.3803/enm.2024.2264 · Cited by 72 · see citing works
Cheong, L., Law, L. S.-C., Tan, L. Y. L., Amal, A. A.-A., Khoo, C. M., & Eng, P. C. (2025) · Nutrients · doi:10.3390/nu17071210 · Cited by 14 · see citing works
Cai, M., Jiang, X., Xu, X., Zhao, S., Sun, Y., Yang, Y., Yang, P., Chen, F., & Huang, Y. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02744-2 · Cited by 5 · see citing works
Maloney, A. C., Barnas, J., Clart, L., Vieira‐Potter, V. J., & Kanaley, J. A. (2025) · Journal of Endocrinology · doi:10.1530/joe-25-0043 · Cited by 3 · see citing works
Wishlade, T., Wetzler, S. R., & Aiken, C. (2025) · AJOG Global Reports · doi:10.1016/j.xagr.2025.100527 · Cited by 2 · see citing works
Gene Expression Profile of Placenta and Adipose Tissue in Women with Gestational Diabetes Mellitus
Saucedo, R., Magallón-Gayón, E., Chávez-Santoscoy, R. A., Díaz-Velázquez, M. F., Ferreira‐Hermosillo, A., Ojeda-López, D. M., Porras-Marcial, W., López-Sánchez, D., & Valencia‐Ortega, J. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26199595 · Cited by 2 · see citing works
Xie, Y., Wen, Y., Wen, X., Zhang, B., & Zhao, J. (2026) · Current Issues in Molecular Biology · doi:10.3390/cimb48101053
Zhang, Q., Yang, S., & Gao, Y. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1953251
- Authors
- McElwain, C. J., Manna, S., Musumeci, A., Sylvester, I., Rouchon, C., O'Callaghan, A. M., Ebad, M. A. B., McCarthy, F. P., & McCarthy, C. M.
- Affiliations
- University College Cork (IE)
- Cork University Hospital (IE)
- Corresponding author
- McCarthy, Cathal M
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2023-11-30
- Volume
- 109
- Issue
- 5
- Pages
- 1275-1284
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC11031241
- OpenAlex
- W4389208235
- Cited by
- 7
- References
- 38
- Citations by year
- 2026: 1 · 2025: 6
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion, cc-by)
- Funders
- HRB
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- gestational diabetes mellitus, visceral adipose tissue, maternal obesity, insulin resistance, hyperinsulinemia, insulin receptor substrate 2, insulin signaling, leptin, adipsin, adiponectin, placenta, adipose tissue remodeling
- MeSH terms
- Adipose Tissue, Cross-Sectional Studies, Female, Humans, Insulin, Insulin Resistance, Obesity, Placenta, Pregnancy, Complement Factor D, Diabetes, Gestational, Intra-Abdominal Fat
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
