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. 2015 Feb 10;22(8):1028–1036. doi: 10.1177/1933719115570908

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© The Author(s) 2015

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Figure 3. — Possible relationships between maternal and placental cytokines and syncytiotrophoblast levels of visfatin/Nampt and SIRT1. Interleukin 6 (IL-6) in maternal plasma was significantly related to prepregnancy BMI (P < .0001) but unrelated to levels of visfatin/Nampt in the syncytiotrophoblast (P = .727). However, visfatin/Nampt in the syncytiotrophoblast was linearly and significantly (P = .021) related to maternal BMI (not shown). Other proinflammatory cytokines in the maternal circulation or those produced within the placenta may be causing increased syncytiotrophoblast visfatin/Nampt in obesity (dashed lines). The visfatin in maternal plasma was unrelated to maternal BMI but maybe related to the amount of visceral fat present (dashed line). Both the plasma visfatin and placental visfatin/Nampt increased placental levels of SIRT1 (P = .028 and .017, respectively), and SIRT1 is anti-inflammatory and a negative regulator of the matrix metalloproteinases. However, there was no relationship between placental SIRT1 and maternal BMI. This suggests that the increased visfatin/Nampt in obesity may keep SIRT1 stable in the syncytiotrophoblast, delaying the proinflammatory events leading to spontaneous labor and causing a greater incidence of postterm deliveries in obese patients. BMI indicates body mass index; SIRT1, sirtuin 1.