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. 2020 Feb;8(1):e000864.
doi: 10.1136/bmjdrc-2019-000864.

Fetuin-A and fetal growth in gestational diabetes mellitus

Wen-Juan Wang #  1   2 , Lin Zhang #  3 , Tao Zheng  3 , Guang-Hui Zhang  4 , Kun Du  4 , Meng-Nan Yang  1   3 , Hua He  1   5 , Shufan Wang  2 , Weiye Wang  1 , Jun Zhang  1 , Fengxiu Ouyang  6 , Zhong-Cheng Luo  6   2 ; Shanghai Birth Cohort
Affiliations

Fetuin-A and fetal growth in gestational diabetes mellitus

Wen-Juan Wang et al. BMJ Open Diabetes Res Care. 2020 Feb.

Abstract

Objective: Fetuin-A is a glycoprotein produced by hepatocytes and has been associated with insulin resistance and bone growth in postnatal life. Gestational diabetes mellitus (GDM) is a condition characterized by insulin resistance. It is unclear whether GDM may affect cord blood fetuin-A levels and whether fetuin-A is associated with fetal growth.

Research design and methods: In a nested case-control study of 153 matched pairs of neonates of mothers with GDM and euglycemic pregnancies in the Shanghai Birth Cohort, we evaluated cord blood fetuin-A in association with GDM and fetal growth.

Results: Comparing the newborns of GDM versus euglycemic mothers, cord blood fetuin-A concentrations were similar (mean±SD: 783.6±320.0 vs 754.8±281.9 µg/mL, p=0.53), while insulin-like growth factor (IGF)-I (76.6±27.8 ng/mL vs 68.1±25.1 ng/mL, p=0.008) and IGF-II (195.3±32.5 ng/mL vs 187.5±30.8 ng/mL, p=0.042) concentrations were higher. Cord blood fetuin-A was not correlated with insulin, IGF-I or IGF-II. Cord blood fetuin-A was negatively correlated with birth weight (r=-0.19, p=0.025) and birth length (r=-0.24, p=0.005) z scores in GDM pregnancies, while there were no significant correlations in euglycemic pregnancies (tests for interaction: p=0.014 for birth length, p=0.013 for birth length). Adjusting for maternal and neonatal characteristics, the differential associations remained.

Conclusions: GDM was not associated with cord blood fetuin-A levels. Fetuin-A was negatively associated with fetal growth in GDM but not in euglycemic pregnancies. This novel observation suggests a GDM-conditional negative correlation of fetuin-A with fetal growth.

Keywords: fetal growth; fetuin; gestational diabetes mellitus; human umbilical cord blood.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart in the selection of study subjects in a nested matched case–control study of the newborns of GDM mothers and controls in the Shanghai Birth Cohort. GDM, gestational diabetes mellitus.
Figure 2
Figure 2
Hypothetical conditional association of fetuin-A with fetal growth in GDM pregnancies. GDM, gestational diabetes mellitus.
See this image and copyright information in PMC

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