Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 28:12:630287.
doi: 10.3389/fendo.2021.630287. eCollection 2021.

FGF21 Serum Levels in the Early Second Trimester Are Positively Correlated With the Risk of Subsequent Gestational Diabetes Mellitus: A Propensity-Matched Nested Case-Control Study

Zhiheng Wang  1 , Min Yuan  2 , Chengjie Xu  3 , Yang Zhang  2 , Chunmei Ying  1 , Xirong Xiao  2
Affiliations

FGF21 Serum Levels in the Early Second Trimester Are Positively Correlated With the Risk of Subsequent Gestational Diabetes Mellitus: A Propensity-Matched Nested Case-Control Study

Zhiheng Wang et al. Front Endocrinol (Lausanne). .

Abstract

Background: As an important endocrine hormone regulating glucose metabolism, fibroblast growth factor 21 (FGF21) is increased in individuals with gestational diabetes mellitus (GDM) after 24 gestational weeks. However, it is unknown whether the increase in FGF21 precedes the diagnosis of GDM.

Methods: In this nested case-control study, 133 pregnant women with GDM and 133 pregnant women with normal glucose tolerance (NGT) were identified through propensity score matching, and serum FGF21 levels were measured at 14 to 21 gestational weeks, before GDM is routinely identified. The differences in FGF21 levels were compared. The association between FGF21 and the occurrence of GDM was evaluated using logistic regression models with adjustment for confounders.

Results: The serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall (P < 0.001), with similar results observed between the corresponding BMI subgroups (P < 0.05). The 2nd (OR 1.224, 95% CI 0.603-2.485), 3rd (OR 2.478, 1.229-5.000), and 4th (OR 3.419, 95% CI 1.626-7.188) FGF21 quartiles were associated with greater odds of GDM occurrence than the 1st quartile after multivariable adjustments.

Conclusions: The serum FGF21 levels in GDM groups increased in the early second trimester, regardless of whether participants were stratified according to BMI. After adjusting for confounding factors, the FGF21 levels in the highest quartile were associated with more than three times higher probability of the diagnosis of GDM in the pregnancy as compared to levels in the first quartile.

Keywords: FGF21; early second trimester; gestational diabetes mellitus (GDM); nested case-control study; propensity score matching (PSM).

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flowchart of the selection of the analyzed GDM population and the matched control population.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Gao S, Leng J, Liu H, Wang S, Li W, Wang Y, et al. . Development and Validation of an Early Pregnancy Risk Score for the Prediction of Gestational Diabetes Mellitus in Chinese Pregnant Women. BMJ Open Diabetes Res Care (2020) 8(1):e000909. 10.1136/bmjdrc-2019-000909 - DOI - PMC - PubMed
    1. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational Diabetes Mellitus. Nat Rev Dis Primers (2019) 5(1):47. 10.1038/s41572-019-0098-8 - DOI - PubMed
    1. Yan J, Yang H. Gestational Diabetes in China: Challenges and Coping Strategies. Lancet Diabetes Endocrinol (2014) 2(12):930–1. 10.1016/S2213-8587(14)70154-8 - DOI - PubMed
    1. Zhu WW, Fan L, Yang HX, Kong LY, Su SP, Wang ZL, et al. . Fasting Plasma Glucose At 24-28 Weeks to Screen for Gestational Diabetes Mellitus: New Evidence From China. Diabetes Care (2013) 36(7):2038–40. 10.2337/dc12-2465 - DOI - PMC - PubMed
    1. Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to Type 2 Diabetes in Women With a Known History of Gestational Diabetes: Systematic Review and Meta-Analysis. BMJ (2020) 369:m1361. 10.1136/bmj.m1361 - DOI - PMC - PubMed

Publication types

Substances