Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Front Endocrinol (Lausanne). 2021 Apr 28;12:630287. doi: 10.3389/fendo.2021.630287. eCollection 2021.
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.
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.
The serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall ( < 0.001), with similar results observed between the corresponding BMI subgroups ( < 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.
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.
成纤维细胞生长因子 21（FGF21）作为一种重要的调节葡萄糖代谢的内分泌激素，在妊娠 24 周后患有妊娠期糖尿病（GDM）的个体中增加。然而，目前尚不清楚 FGF21 的增加是否先于 GDM 的诊断。
在这项巢式病例对照研究中，通过倾向评分匹配确定了 133 例患有 GDM 的孕妇和 133 例糖耐量正常（NGT）的孕妇，并在 14 至 21 周的妊娠期间测量了血清 FGF21 水平，此时 GDM 尚未常规诊断。比较了 FGF21 水平的差异。使用调整混杂因素的逻辑回归模型评估了 FGF21 与 GDM 发生之间的关联。
14 至 21 周妊娠时，GDM 组的血清 FGF21 水平总体上明显高于 NGT 组（<0.001），在相应的 BMI 亚组中也观察到了类似的结果（<0.05）。第 2 （OR 1.224，95%CI 0.603-2.485），第 3 （OR 2.478，1.229-5.000）和第 4 （OR 3.419，95%CI 1.626-7.188）四分位数与 GDM 发生的可能性大于多变量调整后的第 1 四分位数。
无论是否根据 BMI 对参与者进行分层，GDM 组的血清 FGF21 水平在妊娠中期早期均升高。在调整混杂因素后，与第 1 四分位数相比，最高四分位数的 FGF21 水平与 GDM 诊断的可能性增加三倍以上相关。
