Abstract: Objective：To investigate the dynamic changes of adiponectin and the correlation with gestational diabetes mellitus（GDM），and its prediction of the risk and prognosis in GDM. Methods：A nested case-control study was undertaken. 91 women with GDM，including 60 cases without insulin treatment（A1） and 31 cases with insulin treatment（A2）. 32 women with normal glucose tolerance in control group. Maternal and umbilical plasma adiponectin were determined by enzyme linked immunosorbent assay（ELISA）. The expression of adiponectin protein in placental was measured by immunohistochemistry. Results： To compare with controls，maternal adiponectin levels were lower in women with GDM at different stages of pregnancy（P＜0.01，P＜0.01，P＜0.05）. Plasma adiponectin levels were significantly decreased in the second and the third trimester（both P＜0.01）. Umbilical plasma adiponectin levels were not significantly different among 3 groups（P＞0.05）. The expression of adiponectin protein in GDM was much lower than normal pregnant women（P＜0.05）. Conclusions：Hypoadiponectinaemia may be relevant to the pathogenesis of GDM. And this alteration occurs in the first and second trimester. Therefore，detecting adiponectin concentration may predict the risk of GDM at an early stage of pregnancy. Further studies are required to verify whether the cytokine plays a role in fetal intrauterine growth.

Key words: Adiponectin, Diabetes, gestational, Insulin resistance, Case-control studies