Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 572-584
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.572
Adiponectin gene polymorphisms and risk of gestational diabetes mellitus: A meta-analysis
Lin-Ting Huang, Shi-Lan Wu, Xin Liao, Shu-Juan Ma, Hong-Zhuan Tan
Lin-Ting Huang, Shi-Lan Wu, Xin Liao, Shu-Juan Ma, Hong-Zhuan Tan, Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410083, Hunan Province, China
Author contributions: Huang LT conceived the study, acquired, analyzed, and interpreted the data, and drafted the manuscript; Wu SL and Xin L acquired, analyzed, and interpreted the data and revised the manuscript; Ma SJ interpreted the data and revised the manuscript; Tan HZ conceived and designed the study and critically revised the manuscript. All author approved the final version of the manuscript.
Supported by the National Nature Science Foundation of China, No. 81773535.
Conflict-of-interest statement: The authors deny any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hong-Zhuan Tan, MD, PhD, Professor, Xiangya School of Public Health, Central South University, Changsha 410008, Hunan Province, China.
Telephone: +86-731-88858435 Fax: +86-731-84805454
Received: November 20, 2018
Peer-review started: November 21, 2018
First decision: December 15, 2018
Revised: December 24, 2018
Accepted: January 3, 2019
Article in press: January 3, 2019
Published online: March 6, 2019

Adiponectin (ADIPOQ) is an important factor involved in the regulation of both carbohydrate and lipid metabolism. Polymorphisms in the ADIPOQ gene are known to influence an individual’s predisposition to metabolic syndrome and type 2 diabetes. Moreover, women with gestational diabetes mellitus (GDM) are at an increased risk of developing type 2 diabetes. Several studies have been conducted previously to assess the association between ADIPOQ polymorphisms and GDM; however, the results of the association are inconclusive.


To quantitatively evaluate the association between ADIPOQ +45T/G, +276G/T, and -11377C/G polymorphisms and the risk of GDM.


A systematic search of EMBASE, PubMed, CNKI, Web of Science, and WANFANG DATA was conducted up to October 20, 2018. We calculated merged odds ratios (ORs) with 95% confidence intervals (CIs) using a fixed-effects or random-effects model depending on the between-study heterogeneity to evaluate the association between AIDPOQ +45T/G, +276G/T, and -11377C/G polymorphisms and the risk of GDM. Subgroup analysis was performed by ethnicity. Publication and sensitivity bias analyses were performed to test the robustness of the association. All statistical analyses were conducted using Stata12.0.


Nine studies of +45T/G included 1024 GDM cases and 1059 controls, five studies of +276G/T included 590 GDM cases and 595 controls, and five studies of -11377C/G included 722 GDM cases and 791 controls. Pooled ORs indicated that +45T/G increased GDM risk in Asians (allelic model: OR = 1.47, 95%CI: 1.27-1.70, P = 0.000; dominant model: OR = 1.54, 95%CI: 1.27-1.85, P = 0.000; recessive model: OR=2.00, 95%CI: 1.43-2.85, P = 0.000), not in South Americans (allelic model: OR = 1.21, 95%CI: 0.68-2.41, P = 0.510; dominant model: OR = 1.13, 95%CI: 0.59-2.15, P = 0.710; recessive model: OR = 2.18, 95%CI: 0.43-11.07, P = 0.350). There were no significant associations between +276G/T (allelic model: OR = 0.88, 95%CI: 0.74-1.05, P = 0.158; dominant model: OR = 0.91, 95%CI: 0.65-1.26, P = 0.561; recessive model: OR = 0.82, 95%CI: 0.64-1.05, P = 0.118) or -11377C/G (allelic model: OR = 0.96, 95%CI: 0.72-1.26, P = 0.750; dominant model: OR = 1.00, 95%CI: 0.73-1.37, P = 0.980; recessive model: OR = 0.90, 95%CI: 0.61-1.32, P = 0.570) and the risk of GDM.


Our meta-analysis shows the critical role of the ADIPOQ +45T/G polymorphism in GDM, especially in Asians. Studies focused on delineating ethnicity-specific factors with larger sample sizes are needed.

Keywords: Gestational diabetes mellitus, Single nucleotide, Polymorphism, Adiponectin, Gene, Meta-analysis

Core tip: No consensus is available in the literature about the association of adiponectin gene polymorphisms and the risk of gestational diabetes mellitus (GDM). As far as we know, only +45T/G was involved in a previous meta-analysis with a small sample size and obvious heterogeneity. We evaluated the association between ADIPOQ +45T/G, +276G/T, and -11377C/G polymorphisms and GDM with a bigger sample size, less heterogeneity. Moreover, subgroup analysis was performed by ethnicity.