Association of Systemic Inflammation with Inflammatory mRNA Expression in Visceral Adipose Tissue in Gestational Diabetes
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Analytical Methods
2.3. VAT mRNA Extraction and cDNA Synthesis
2.4. Quantitative Real-Time RT-PCR
2.5. Statistical Analysis
3. Results
3.1. Characteristics of the Participants
3.2. Gene Expression in VAT from the Patients with and Without GDM
3.3. Correlations Between Inflammation VAT Gene Expression as Well as Maternal Clinical Parameters and Systemic Inflammation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Wang, H.; Li, N.; Chivese, T.; Werfalli, M.; Sun, H.; Yuen, L.; Hoegfeldt, C.A.; Powe, C.E.; Immanuel, J.; Karuranga, S.; et al. IDF Diabetes Atlas Committee Hyperglycaemia in Pregnancy Special Interest Group. IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Res. Clin. Pract. 2022, 183, 109050. [Google Scholar] [CrossRef]
- Shah, N.S.; Wang, M.C.; Freaney, P.M.; Perak, A.M.; Carnethon, M.R.; Kandula, N.R.; Gunderson, E.P.; Bullard, K.M.; Grobman, W.A.; O’bRien, M.J.; et al. Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011–2019. JAMA 2021, 326, 660–669. [Google Scholar] [CrossRef] [PubMed]
- Chen, L.; Mayo, R.; Chatry, A.; Hu, G. Gestational diabetes mellitus: Its epidemiology and implication beyond pregnancy. Curr. Epidemiol. Rep. 2016, 3, 1–11. [Google Scholar] [CrossRef]
- HAPO Study Cooperative Research Group; Metzger, B.E.; Lowe, L.P.; Dyer, A.R.; Trimble, E.R.; Chaovarindr, U.; Coustan, D.R.; Hadden, D.R.; McCance, D.R.; Hod, M.; et al. Hyperglycemia and adverse pregnancy outcomes. N. Engl. J. Med. 2008, 358, 1991–2002. [Google Scholar] [CrossRef]
- Bellamy, L.; Casas, J.-P.; Hingorani, A.D.; Williams, D. Type 2 diabetes mellitus after gestational diabetes: A systematic review and meta-analysis. Lancet 2009, 373, 1773–1779. [Google Scholar] [CrossRef] [PubMed]
- Abell, S.K.; De Courten, B.; Boyle, J.A.; Teede, H.J. Inflammatory and other biomarkers: Role in pathophysiology and prediction of gestational diabetes mellitus. Int. J. Mol. Sci. 2015, 16, 13442–13473. [Google Scholar] [CrossRef]
- Valencia-Ortega, J.; González-Reynoso, R.; Ramos-Martínez, E.G.; Ferreira-Hermosillo, A.; Peña-Cano, M.I.; Morales-Ávila, E.; Saucedo, R. New insights into adipokines in gestational diabetes mellitus. Int. J. Mol. Sci. 2022, 23, 6279. [Google Scholar] [CrossRef]
- Sun, X.; Sun, H.; Li, P. Association of circulating inflammatory cells and platelets with gestational diabetes and pregnancy outcomes. Clin. Chim Acta. 2021, 523, 87–96. [Google Scholar] [CrossRef] [PubMed]
- Kim, S.Y.; England, L.; Wilson, H.G.; Bish, C.; Satten, G.A.; Dietz, P. Percentage of gestational diabetes mellitus attributable to overweight and obesity. Am. J. Public Health 2010, 100, 1047–1052. [Google Scholar] [CrossRef] [PubMed]
- Sureshchandra, S.; Marshall, N.E.; Wilson, R.M.; Barr, T.; Rais, M.; Purnell, J.Q.; Thornburg, K.L.; Messaoudi, I. Inflammatory determinants of pregravid obesity in placenta and peripheral blood. Front. Physiol. 2018, 9, 1089. [Google Scholar] [CrossRef]
- Kawai, T.; Autieri, M.V.; Scalia, R. Adipose tissue inflammation and metabolic dysfunction in obesity. Am. J. Physiol. Cell Physiol. 2021, 320, C375–C391. [Google Scholar] [CrossRef]
- Luo, Y.; Liu, M. Adiponectin: A versatile player of innate immunity. J. Mol. Cell Biol. 2016, 8, 120–128. [Google Scholar] [CrossRef]
- Kumada, M.; Kihara, S.; Ouchi, N.; Kobayashi, H.; Okamoto, Y.; Ohashi, K.; Maeda, K.; Nagaretani, H.; Kishida, K.; Maeda, N.; et al. Adiponectin specifically increased tissue inhibitor of metalloproteinase-1 through interleukin-10 expression in human macrophages. Circulation 2004, 109, 2046–2049. [Google Scholar] [CrossRef]
- Cinkajzlová, A.; Anderlová, K.; Šimják, P.; Lacinová, Z.; Kloučková, J.; Kratochvílová, H.; Krejčí, H.; Pařízek, A.; Mráz, M.; Kršek, M.; et al. Subclinical inflammation and adipose tissue lymphocytes in pregnant females with gestational diabetes mellitus. J. Clin. Endocrinol. Metab. 2020, 105, e3892–e3902. [Google Scholar] [CrossRef]
- Lee, B.; Janzen, C.; Wu, H.; Vangala, S.S.; Devaskar, S.U.; Sung, K. Utility of in vivo magnetic resonance imaging is predictive of gestational diabetes mellitus during early pregnancy. J. Clin. Endocrinol. Metab. 2023, 108, 281–294. [Google Scholar] [CrossRef]
- Alwash, S.M.; McIntyre, H.D.; Mamun, A. The association of general obesity, central obesity and visceral body fat with the risk of gestational diabetes mellitus: Evidence from a systematic review and meta-analysis. Obes. Res. Clin. Pract. 2021, 15, 425–430. [Google Scholar] [CrossRef]
- Rancourt, R.C.; Ott, R.; Ziska, T.; Schellong, K.; Melchior, K.; Henrich, W.; Plagemann, A. Visceral adipose tissue inflammatory factors (TNF-alpha, SOCS3) in gestational diabetes (GDM): Epigenetics as a clue in GDM pathophysiology. Int. J. Mol. Sci. 2020, 21, 479. [Google Scholar] [CrossRef]
- Maloney, A.C.; Barnas, J.L.; Clart, L.M.; Vieira-Potter, V.J.; A Kanaley, J. Metabolic dysfunction is exacerbated in visceral, not subcutaneous, adipose tissue in gestational diabetes. J. Endocrinol. 2025, 265, e250043. [Google Scholar] [CrossRef] [PubMed]
- Peña-Cano, M.I.; Valencia-Ortega, J.; Morales-Ávila, E.; Díaz-Velázquez, M.F.; Gómez-Díaz, R.; Saucedo, R. Omentin-1 and its relationship with inflammatory factors in maternal plasma and visceral adipose tissue of women with gestational diabetes mellitus. J. Endocrinol. Investig. 2022, 45, 453–462. [Google Scholar] [CrossRef] [PubMed]
- Faul, F.; Erdfelder, E.; Lang, A.-G.; Buchner, A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 2007, 39, 175–191. [Google Scholar] [CrossRef] [PubMed]
- Sun, T.; Meng, F.; Zhao, H.; Yang, M.; Zhang, R.; Yu, Z.; Huang, X.; Ding, H.; Liu, J.; Zang, S. Elevated first-trimester neutrophil count is closely associated with the development of maternal gestational diabetes mellitus and adverse pregnancy outcomes. Diabetes 2020, 69, 1401–1410. [Google Scholar] [CrossRef]
- Sahin, M.; Oguz, A.; Tüzün, D.; Işiktaş, O.; Işiktaş, S.; Ülgen, C.; Şahin, H.; Gul, K. A new marker predicting gestational diabetes mellitus: First trimester neutrophil/lymphocyte ratio. Medicine 2022, 101, e30514. [Google Scholar] [CrossRef]
- Talukdar, S.; Oh, D.Y.; Bandyopadhyay, G.; Li, D.; Xu, J.; McNelis, J.; Lu, M.; Li, P.; Yan, Q.; Zhu, Y.; et al. Neutrophils mediate insulin resistance in mice fed a high-fat diet through secreted elastase. Nat. Med. 2012, 18, 1407–1412. [Google Scholar] [CrossRef]
- Angelo, A.G.S.; Neves, C.T.C.; Lobo, T.F.; Godoy, R.V.C.; Ono, É.; Mattar, R.; Daher, S. Monocyte profile in peripheral blood of gestational diabetes mellitus patients. Cytokine 2018, 107, 79–84. [Google Scholar] [CrossRef]
- Huang, X.; Zha, B.; Zhang, M.; Li, Y.; Wu, Y.; Zhang, R.; Sheng, L.; Xu, J.; Yu, Z.; Gao, C.; et al. Decreased monocyte count is associated with gestational diabetes mellitus development, macrosomia, and inflammation. J. Clin. Endocrinol. Metab. 2022, 107, 192–204. [Google Scholar] [CrossRef] [PubMed]
- Liu, G.; Geng, J.; Jin, R.; Zhang, N.; Mei, L. The clinical significance of complete blood count, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in gestational diabetes mellitus. Acta. Endocrinol. 2023, 19, 441–446. [Google Scholar] [CrossRef] [PubMed]
- Sargin, M.A.; Yassa, M.; Taymur, B.D.; Celik, A.; Ergun, E.; Tug, N. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: Are they useful for predicting gestational diabetes mellitus during pregnancy? Ther. Clin. Risk Manag. 2016, 12, 657–665. [Google Scholar] [CrossRef] [PubMed]
- Simsek, D.; Akselim, B.; Altekin, Y. Do patients with a single abnormal OGTT value need a globally admitted definition such as “borderline GDM”? Pregnancy outcomes of these women and the evaluation of new inflammatory markers. J. Matern. Fetal Neonatal Med. 2021, 34, 3782–3789. [Google Scholar] [CrossRef]
- Kato, M.; Suzuki, M.; Hayashi, Y.; Kimura, H. Role of eosinophils and their clinical significance in allergic inflammation. Expert Rev. Clin. Immunol. 2006, 2, 121–133. [Google Scholar] [CrossRef]
- Zhang, K.; Shi, X.; Bian, R.; Shi, W.; Yang, L.; Ren, C. Identification and validation of palmitoylation-related biomarkers in gestational diabetes mellitus. Sci. Rep. 2025, 15, 8019. [Google Scholar] [CrossRef]
- Buschmann, C.; Unverdorben, L.; Knabl, J.; Hutter, S.; Meister, S.; Beyer, S.; Burgmann, M.; Keilmann, L.; Zehni, A.Z.; Schmoeckel, E.; et al. Galectin-10 Expression in Placentas of Women with Gestational Diabetes. Curr. Issues Mol. Biol. 2023, 45, 8840–8851. [Google Scholar] [CrossRef]
- Gelaw, Y.; Asrie, F.; Walle, M.; Getaneh, Z. The value of eosinophil count in the diagnosis of preeclampsia among pregnant women attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021. BMC Pregnancy Childbirth 2022, 22, 557. [Google Scholar] [CrossRef] [PubMed]
- Wang, J.; Zhu, Q.-W.; Cheng, X.-Y.; Sha, C.-X.; Cui, Y.-B. Clinical significance of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in women with hyperglycemia. Postgrad. Med. 2020, 132, 702–708. [Google Scholar] [CrossRef]
- Liu, W.; Lou, X.; Zhang, Z.; Chai, Y.; Yu, Q. Association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume with the risk of gestational diabetes mellitus. Gynecol. Endocrinol. 2021, 37, 105–107. [Google Scholar] [CrossRef]
- Hessami, K.; Tabrizi, R.; Homayoon, N.; Hashemi, A.; Heydari, S.T.; Pourhoseini, S.A. Gestational diabetes mellitus and inflammatory biomarkers of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio: A systematic review and meta-analysis. Biomarkers 2021, 26, 491–498. [Google Scholar] [CrossRef] [PubMed]
- Pace, N.P.; Vassallo, J. Association Between Neutrophil-Lymphocyte Ratio and Gestational Diabetes-A Systematic Review and Meta-Analysis. J. Endocr. Soc. 2021, 5, bvab051. [Google Scholar] [CrossRef]
- Angkananard, T.; Anothaisintawee, T.; McEvoy, M.; Attia, J.; Thakkinstian, A. Neutrophil lymphocyte ratio and cardiovascular disease risk: A systematic review and meta-analysis. BioMed Res. Int. 2018, 2018, 2703518. [Google Scholar] [CrossRef] [PubMed]
- Mertoglu, C.; Gunay, M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab. Syndr. Clin. Res. Rev. 2017, 11, S127–S131. [Google Scholar] [CrossRef]
- Yıldırım, S.B.; Altuntas, N.B.; Tekin, Y.B. Monocyte-to-lymphocyte ratio in the early second trimester is a predictor of gestational diabetes mellitus. J. Matern. Fetal Neonatal Med. 2024, 37, 2371979. [Google Scholar] [CrossRef]
- Retnakaran, R.; Qi, Y.; Connelly, P.W.; Sermer, M.; Hanley, A.J.; Zinman, B. Low adiponectin concentration during pregnancy predicts postpartum insulin resistance, beta cell dysfunction and fasting glycaemia. Diabetologia 2010, 53, 268–276. [Google Scholar] [CrossRef] [PubMed]
- Skvarca, A.; Tomazic, M.; Krhin, B.; Blagus, R.; Janez, A. Adipocytokines and insulin resistance across various degrees of glucose tolerance in pregnancy. J. Int. Med Res. 2012, 40, 583–589. [Google Scholar] [CrossRef]
- Ohashi, K.; Parker, J.L.; Ouchi, N.; Higuchi, A.; Vita, J.A.; Gokce, N.; Pedersen, A.A.; Kalthoff, C.; Tullin, S.; Sams, A.; et al. Adiponectin promotes macrophage polarization toward an anti-inflammatory phenotype. J. Biol. Chem. 2010, 285, 6153–6160. [Google Scholar] [CrossRef]
- Muntean, M.; Săsăran, V.; Luca, S.-T.; Suciu, L.M.; Nyulas, V.; Mărginean, C. Serum Levels of Adipolin and Adiponectin and Their Correlation with Perinatal Outcomes in Gestational Diabetes Mellitus. J. Clin. Med. 2024, 13, 4082. [Google Scholar] [CrossRef] [PubMed]
- Kuzmicki, M.; Telejko, B.; Zonenberg, A.; Szamatowicz, J.; Kretowski, A.; Nikolajuk, A.; Laudanski, P.; Gorska, M. Circulating pro- and anti-inflammatory cytokines in Polish women with gestational diabetes. Horm. Metab. Res. 2008, 40, 556–560. [Google Scholar] [CrossRef] [PubMed]
- Kleiblova, P.; Dostalova, I.; Bartlova, M.; Lacinova, Z.; Ticha, I.; Krejci, V.; Springer, D.; Kleibl, Z.; Haluzik, M. Expression of adipokines and estrogen receptors in adipose tissue and placenta of patients with gestational diabetes mellitus. Mol. Cell. Endocrinol. 2010, 314, 150–156. [Google Scholar] [CrossRef]
- Dong, Y.; Chauhan, M.; Betancourt, A.; Belfort, M.; Yallampalli, C. Adipose tissue inflammation and adrenomedullin Overexpression contribute to lipid dysregulation in diabetic pregnancies. J. Clin. Endocrinol. Metab. 2018, 103, 3810–3818. [Google Scholar] [CrossRef]
- Ott, R.; Stupin, J.H.; Melchior, K.; Schellong, K.; Ziska, T.; Dudenhausen, J.W.; Henrich, W.; Rancourt, R.C.; Plagemann, A. Alterations of adiponectin gene expression and DNA methylation in adipose tissues and blood cells are associated with gestational diabetes and neonatal outcome. Clin. Epigenetics 2018, 10, 131. [Google Scholar] [CrossRef]
- Telejko, B.; Kuzmicki, M.; Wawrusiewicz-Kurylonek, N.; Szamatowicz, J.; Nikolajuk, A.; Zonenberg, A.; Zwierz-Gugala, D.; Jelski, W.; Laudański, P.; Wilczynski, J.; et al. Plasma apelin levels and apelin/APJ mRNA expression in patients with gestational diabetes mellitus. Diabetes Res. Clin. Pract. 2010, 87, 176–183. [Google Scholar] [CrossRef] [PubMed]
- Huh, J.Y.; Park, Y.J.; Ham, M.; Kim, J.B. Crosstalk between adipocytes and immune cells in adipose tissue inflammation and metabolic dysregulation in obesity. Mol. Cells 2014, 37, 365–371. [Google Scholar] [CrossRef]
- Harlev, A.; Aricha-Tamir, B.; Shaco-Levy, R.; Tarnovscki, T.; Bashan, N.; Rudich, A.; Sheiner, E.; Press, F.; Wiznitzer, A. Macrophage infiltration and stress-signaling in omental and subcutaneous adipose tissue in diabetic pregnancies. J. Matern. Fetal Neonatal Med. 2014, 27, 1189–1194. [Google Scholar] [CrossRef]
- Musumeci, A.; McElwain, C.J.; Manna, S.; McCarthy, F.; McCarthy, C. Exposure to gestational diabetes mellitus increases subclinical inflammation mediated in part by obesity. Clin. Exp. Immunol. 2024, 216, 280–292. [Google Scholar] [CrossRef] [PubMed]
- Marichal, T.; Mesnil, C.; Bureau, F. Homeostatic eosinophils: Characteristics and functions. Front. Med. 2017, 4, 101. [Google Scholar] [CrossRef] [PubMed]
NGT (n = 50) | GDM (n= 50) | p | |
---|---|---|---|
Age (year) | 30.0 (22–33) | 29.0 (27–33) | 0.353 |
BMI before pregnancy (kg/m2) | 25.6 (23.2–27.3) | 29.5 (26.7–33.9) | 0.001 |
GWG (kg) | 10 (7.8–11.6) | 9 (6.8–11.0) | 0.332 |
Gestational age (weeks) | 39.0 (38.0–39.6) | 38.0 (37.5–39.0) | 0.013 |
Fasting glucose (mmol/L) | 4.3 (3.8–5.1) | 4.8 (4.1–5.5) | 0.040 |
Total cholesterol (mmol/L) | 6.1 (5.2–8.3) | 5.4 (4.8–6.5) | 0.036 |
Triglycerides (mmol/L) | 3.1 (2.5–3.6) | 3.1 (2.2–3.8) | 0.691 |
HDL (mmol/L) | 2.7 (2.3–3.1) | 2.4 (1.9–2.8) | 0.039 |
LDL (mmol/L) | 1.9 (1.2–2.3) | 1.4 (0.8–2.2) | 0.122 |
VLDL (mmol/L) | 1.4 (1.2–1.7) | 1.4 (1.0–1.8) | 0.537 |
Insulin (pmol/L) | 51.8 (30.0–73.4) | 53.8 (34.4–79.3) | 0.827 |
HOMA-IR | 1.3 (0.82–2.1) | 1.6 (1.1–2.5) | 0.224 |
Leukocyte count (×109/L) | 8.8 (7.7–9.7) | 8.9 (8.2–9.9) | 0.192 |
Neutrophil count (×109/L) | 5.7 (5.1–6.7) | 6.5 (5.4–7.5) | 0.035 |
Lymphocyte count (×109/L) | 2.3 (1.9–2.7) | 2.0 (1.7–2.4) | 0.021 |
Monocyte count (×109/L) | 0.5 (0.4–0.6) | 0.6 (0.5–0.7) | 0.027 |
Eeosinophil count (×109/L) | 0.10 (0.08–0.14) | 0.06 (0.03–0.10) | 0.001 |
Basophil count (×109/L) | 0.03 (0.02–0.04) | 0.02 (0.02–0.03) | 0.441 |
NLR | 2.5 (2.1–2.9) | 3.2 (2.5–4.2) | 0.001 |
MLR | 0.22 (0.16–0.27) | 0.29 (0.21–0.37) | 0.001 |
Adiponectin (pg/mL) | 253.3 (68.3–342.4) | 69.0 (29.2–169.6) | 0.002 |
NGT (n = 50) | GDM (n= 50) | p | |
---|---|---|---|
TLR2 | 0.040 (0.014–0.094) | 0.015 (0.008–0.038) | 0.002 |
TLR4 | 0.067 (0.040–0.096) | 0.033 (0.011–0.104) | 0.017 |
IL-1β | 0.415 (0.220–0.859) | 0.231 (0.106–0.541) | 0.012 |
IL-6 | 0.354 (0.146–0.915) | 0.126 (0.043–0.412) | 0.002 |
TNF-α | 0.022 (0.012–0.031) | 0.022 (0.009–0.033) | 0.767 |
IL-1RA | 0.042 (0.023–0.088) | 0.028 (0.014–0.068) | 0.052 |
IL-10 | 0.104 (0.060–0.218) | 0.048 (0.023–0.131) | 0.001 |
Adiponectin | 0.286 (0.121–1.032) | 0.276 (0.116–1.200) | 0.825 |
r | p | |
---|---|---|
Eosinophil count | ||
TLR2 | 0.263 | 0.012 |
IL-1β | 0.368 | 0.001 |
IL-6 | 0.280 | 0.007 |
TNF-α | 0.214 | 0.042 |
IL-1RA | 0.305 | 0.003 |
IL-10 | 0.344 | 0.001 |
Lymphocyte count | ||
IL-1β | 0.215 | 0.041 |
IL-1RA | 0.231 | 0.027 |
Neutrophil count | ||
IL-6 | −0.211 | 0.043 |
NLR | ||
TLR2 | −0.259 | 0.013 |
IL-6 | −0.257 | 0.013 |
IL-1RA | −0.274 | 0.009 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Saucedo, R.; Peña-Cano, M.I.; Díaz-Velázquez, M.F.; Contreras-Ramos, A.; Moleres-Orduña, M.; López-Sánchez, D.; Valencia-Ortega, J.; Pérez-Duran, J. Association of Systemic Inflammation with Inflammatory mRNA Expression in Visceral Adipose Tissue in Gestational Diabetes. Metabolites 2025, 15, 644. https://doi.org/10.3390/metabo15100644
Saucedo R, Peña-Cano MI, Díaz-Velázquez MF, Contreras-Ramos A, Moleres-Orduña M, López-Sánchez D, Valencia-Ortega J, Pérez-Duran J. Association of Systemic Inflammation with Inflammatory mRNA Expression in Visceral Adipose Tissue in Gestational Diabetes. Metabolites. 2025; 15(10):644. https://doi.org/10.3390/metabo15100644
Chicago/Turabian StyleSaucedo, Renata, María Isabel Peña-Cano, Mary Flor Díaz-Velázquez, Alejandra Contreras-Ramos, Miranda Moleres-Orduña, Debbie López-Sánchez, Jorge Valencia-Ortega, and Javier Pérez-Duran. 2025. "Association of Systemic Inflammation with Inflammatory mRNA Expression in Visceral Adipose Tissue in Gestational Diabetes" Metabolites 15, no. 10: 644. https://doi.org/10.3390/metabo15100644
APA StyleSaucedo, R., Peña-Cano, M. I., Díaz-Velázquez, M. F., Contreras-Ramos, A., Moleres-Orduña, M., López-Sánchez, D., Valencia-Ortega, J., & Pérez-Duran, J. (2025). Association of Systemic Inflammation with Inflammatory mRNA Expression in Visceral Adipose Tissue in Gestational Diabetes. Metabolites, 15(10), 644. https://doi.org/10.3390/metabo15100644