Reduced plasma level of irisin in first trimester as a risk factor for the development of gestational diabetes mellitus.

BACKGROUND

The aim of this prospective cohort study was to investigate the association of first trimester irisin concentrations and the subsequent development of gestational diabetes mellitus (GDM).

METHODS

This cohort study was conducted at three maternity centers in China from July 2015 to June 2016. Data for fasting plasma glucose (FPG) and irisin concentrations in the first trimester and one-step GDM screening with 75-g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks of gestation were collected and analyzed.

RESULTS

Plasma from women was available for 1150 women, of whom 135 (11.7%) developed GDM. The median value of irisin in those included women was 141.2 (IQR, 99.4-192.9) ng/ml. In multivariate models comparing the first (Q1), second (Q2) and third (Q3) quartiles against the fourth (Q4) quartile of irisin, levels of irisin in Q1 and Q2 were associated with GDM, and increased risk of GDM by 440% (odds ratios [OR] = 5.40; 95% confidence intervals [CI]: 2.35-11.40) and 283% (OR: 3.83; 95%CI: 1.63-8.01). A model containing known risk factors plus irisin compared with a model containing known risk factors without irisin showed a greater discriminatory ability to predict GDM, the area under the curve (AUC) increased from 0.776 to 0.809. A significant difference in the AUC between the clinical variables alone and the addition of irisin level was observed (difference, 0.034; P = 0.03).

CONCLUSIONS

Reduced plasma levels of irisin in first trimester was associated with the increased risk of GDM and might be useful in identifying women at risk for GDM for early prevention strategies.