Subclinical inflammation and adipose tissue lymphocytes in pregnant females with gestational diabetes mellitus.

Cinkajzlová, Anna; Anderlová, Kateřina; Šimják, Patrik; Lacinová, Zdeňka; Kloučková, Jana; Kratochvílová, Helena; Krejčí, Hana; Pařízek, Antonín; Mráz, Miloš; Kršek, Michal; Haluzík, Martin

CONTEXT Gestational diabetes mellitus (GDM) is accompanied by subclinical inflammation; however, little is known about local inflammation in adipose tissue and placenta. OBJECTIVE To analyse systemic and local subclinical inflammation and adipose tissue lymphocyte content and phenotype in pregnant females with and without GDM. DESIGN Observational study. SETTINGS Academic hospital. PATIENTS Twenty-one pregnant females with GDM (GDM group), 16 pregnant women without GDM (non-GDM group) and 15 non-pregnant control females (N group). INTERVENTIONS Serum samples taken at 28-32 (V1) and 36-38 (V2) gestational week and 6-12 months after delivery (V3) in GDM and non-GDM group and before elective gynaecological surgery in N group. Subcutaneous (SAT) and visceral adipose tissue (VAT) obtained during Caesarean delivery or surgery. MAIN OUTCOME MEASURES Serum levels and adipose tissue expression of proinflammatory cytokines, adipose tissue lymphocyte content and phenotype (for a subset of GDM and non-GDM subjects). RESULTS Accented proinflammatory state in GDM was documented by increased circulating TNF-α levels. In both groups of pregnant females total lymphocytes were higher in VAT compared to SAT. In GDM subjects B and NKT cells were higher in SAT compared to VAT and Th cells were increased relative to SAT of non-GDM group, while no intercompartmental adipose tissue differences were seen in non-GDM females. CONCLUSIONS Pregnant females had higher total lymphocyte count in VAT relative to SAT regardless of GDM. In addition to increased systemic subclinical inflammation, GDM was associated with significant differences in lymphocyte composition between subcutaneous and visceral adipose tissue depots.