Wu Ping, Wu Linjing, Wang Yi, Ye Yi, Yang Xue, Yuan Jiaying, Xu Jianguo, Wang Yi-Xin, Song Xingyue, Yan Shijiao, Lv Chuanzhu, Liu Gang, Pan An, Pan Xiong-Fei
Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Diabetes Metab Res Rev. 2024 Jan;40(1):e3717. doi: 10.1002/dmrr.3717. Epub 2023 Aug 30.
To examine the prospective association between fibroblast growth factor 21 (FGF21) and risk of gestational diabetes mellitus (GDM) and the modifying effect of overweight/obesity for this association.
Serum FGF21 levels were measured at 6-15 weeks of gestation among 332 GDM cases and 664 matched controls. Conditional logistic regression was used to evaluate its association with GDM risk. Interaction analyses on multiplicative and additive scales were conducted to investigate the modifying effect of overweight/obesity.
Elevated FGF21 levels were associated with a higher risk of GDM in multivariable models, but the positive association was attenuated after further adjustment for pre-pregnancy body mass index (BMI). A significant multiplicative interaction was noted between FGF21 (both continuous and dichotomous) and pre-pregnancy BMI (p for interaction = 0.049 and 0.03), and the association was only significant in participants with pre-pregnancy BMI ≥24 kg/m . When participants were grouped based on pre-pregnancy BMI (≥24 and <24 kg/m ) and FGF21 levels (≥median and <median), a significant association was observed in those with higher BMI and FGF21 levels (odds ratio, 2.12; 95% CI: 1.41, 3.20) but not in those with either higher BMI or higher FGF21, with a significant additive interaction (relative excess risk due to interaction = 1.23; 95% CI: 0.27, 2.20). FGF21 was also correlated with unfavourable glucose and lipid biomarkers as well as adipokines.
Elevated serum FGF21 levels in early pregnancy were associated with a higher risk of GDM, particularly among those with overweight/obesity.
探讨成纤维细胞生长因子21（FGF21）与妊娠期糖尿病（GDM）风险之间的前瞻性关联，以及超重/肥胖对此关联的修饰作用。
在332例GDM病例和664例匹配对照的妊娠6 - 15周时测量血清FGF21水平。采用条件逻辑回归评估其与GDM风险的关联。进行乘法和加法尺度的交互分析以研究超重/肥胖的修饰作用。
在多变量模型中，FGF21水平升高与GDM风险较高相关，但在进一步调整孕前体重指数（BMI）后，这种正相关减弱。FGF21（连续和二分法）与孕前BMI之间存在显著的乘法交互作用（交互作用p = 0.049和0.03），且该关联仅在孕前BMI≥24 kg/m²的参与者中显著。当根据孕前BMI（≥24和<24 kg/m²）和FGF21水平（≥中位数和<中位数）对参与者进行分组时，在BMI和FGF21水平较高的人群中观察到显著关联（比值比，2.12；95%CI：1.41, 3.20），但在仅BMI较高或FGF21较高的人群中未观察到显著关联，存在显著的加法交互作用（交互作用导致的相对超额风险 = 1.23；95%CI：0.27, 2.20）。FGF21还与不良的血糖和脂质生物标志物以及脂肪因子相关。
孕早期血清FGF21水平升高与GDM风险较高相关，尤其是在超重/肥胖者中。
