# Hypoadiponectinemia and Gestational Diabetes

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $466,779

## Abstract

SUMMARY
 Obesity is a key risk factor for Gestational diabetes mellitus (GDM). Due to the obesity epidemic, the
prevalence of GDM has reached an alarming level. Most importantly, GDM has many adverse effects on
pregnancy outcomes and postpartum maternal and offspring health. Therefore, it is urgent to elucidate the
pathological mechanisms of GDM. Adiponectin is an adipocyte-secreted hormone that improves glucose and
lipid metabolism. Hypoadiponectinemia before pregnancy and during the first and second trimesters strongly
predicts GDM. Our studies from the previous funding period have demonstrated that adiponectin deficiency
causes hyperglycemia and other metabolic abnormalities in pregnant mice. Interestingly, our studies revealed
that adiponectin controls maternal metabolic adaptation by indirectly increasing β-cell proliferation and insulin
production via placental lactogen (PL). However, decreased insulin secretion rates were still observed in size-
matched islets from adiponectin gene knockout (Adipoq-/-) dams indicating additional mechanisms are involved
besides β-cell proliferation. Extracellular vesicles (EVs) are well-conserved for intercellular and intra-organ
communication. Pregnancy robustly increases EV levels in maternal circulation, partially attributed to placental-
derived small EVs (psEVs). Consistent with other reports, our preliminary studies observed a stimulative effect
of adiponectin on psEVs production. Importantly, psEVs enhanced glucose-induced insulin secretion of
cultured islets. These data suggest that adiponectin, psEVs, and PL provide a pathway for fat/placenta/islet
intra-organ crosstalk. During the last funding period, our study also identified a crucial role of pancreatic α-cells
in maternal metabolic adaptation. Our study demonstrated that pregnancy increases glucagon-like peptide-1
(GLP-1) production from α-cells and then enhances maternal insulin secretion. A significant reduction of
pancreatic GLP-1 was detected in Adipoq-/- dams. Notably, conditionally knocking out the adiponectin receptor
1 (AdipoR1) gene in α-cells significantly reduced GLP-1 production and glucose tolerance during pregnancy.
Therefore, we hypothesize that adiponectin regulates islet adaptation to pregnancy through both
fat/placenta/islet intra-organ crosstalk and intraislet paracrine. We will use genetic mouse models and human
placenta and islets to 1) define the role of psEVs in adiponectin-regulated islet adaptation to pregnancy; 2)
determine how adiponectin augments maternal insulin production through α-cells. The anticipated success of
this project will have a significant impact on the research of maternal metabolic adaptation.

## Key facts

- **NIH application ID:** 10903864
- **Project number:** 5R01DK113007-06
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Jianhua Shao
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $466,779
- **Award type:** 5
- **Project period:** 2017-12-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10903864

## Citation

> US National Institutes of Health, RePORTER application 10903864, Hypoadiponectinemia and Gestational Diabetes (5R01DK113007-06). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10903864. Licensed CC0.

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