Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. Dec 6, 2024; 13(1): 100776
Published online Dec 6, 2024. doi: 10.5317/wjog.v13.i1.100776
Serum fibroblast growth factor 21: Lack of association with gestational diabetes and pregnancy outcomes
Kuntharee Traisrisilp, Nattayaporn Apaijai, Nipawan Waisayanand, Siriporn Chattipakorn
Kuntharee Traisrisilp, Department of Obstetric and Gynecology, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Nattayaporn Apaijai, Siriporn Chattipakorn, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Nipawan Waisayanand, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Siriporn Chattipakorn, Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Siriporn Chattipakorn, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Author contributions: Traisrisilp K acquired the data and drafted the manuscript; Traisrisilp K, Apaijai N, and Waisayanand N analyzed and interpreted the data; Traisrisilp K, Apaijai N, Waisayanand N, and Chattipakorn S conceived and designed the study; all of the authors read and approved the final version of the manuscript to be published.
Supported by The Faculty of Medicine Research Fund, Chiang Mai University, Thailand, No. 017/2564.
Institutional review board statement: The study was reviewed and approved by the Faculty of Medicine, Chiang Mai University, Institutional Review Board (Approval No. 328/2563).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement–checklist of items, and the manuscript was prepared and revised according to the STROBE Statement–checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kuntharee Traisrisilp, MSc, Doctor, Department of Obstetric and Gynecology, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, 110 Intawaroros Road, Sriphoom District, Muang 50200, Chiang Mai, Thailand. kuntharee.t@cmu.ac.th
Received: August 26, 2024
Revised: October 29, 2024
Accepted: November 22, 2024
Published online: December 6, 2024
Processing time: 100 Days and 2.5 Hours
Abstract
BACKGROUND

The prevalence of gestational diabetes mellitus (GDM) has been increasing worldwide and is associated with multiple adverse pregnancy outcomes. Despite standard screening, some cases remain undiagnosed. Fibroblast growth factor 21 (FGF21) plays a role in modulating glucose metabolism. There is an ongoing controversy regarding the relevance of FGF21 to GDM.

AIM

To evaluate the association between early second trimester serum FGF21 levels and gestational diabetes, and its predictive potential for outcomes.

METHODS

This cross-sectional observational study was conducted at a tertiary medical center, Chiang Mai University, Thailand. It included 28 pregnant women diagnosed with GDM and 81 pregnant women with normal glucose status. Blood samples were collected according to the study schedule, and pregnancy outcomes were recorded meticulously. Descriptive analysis was employed to evaluate the data.

RESULTS

Most participants in our study had no risk factors for GDM (body mass index < 24 kg/m2, no first-degree relatives with diabetes, no history of GDM), normal baseline glucose status (fasting glucose < 110 mg/dL), and no insulin resistance (homeostatic model assessment of insulin resistance < 2). There was a trend of increased FGF21 levels in the insulin-treated GDM group compared with dietary-treated GDM and non-GDM (73.58 pg/mL vs 62.94 pg/mL vs 63.59 pg/mL, respectively, P = 0.73). However, no significant association was found between FGF21 concentrations and pregnancy outcomes based on quintiles of FGF21 levels.

CONCLUSION

FGF21 was not associated with GDM or pregnancy outcomes; however, due to the small sample size, larger clinical trials with a diverse population are suggested to confirm these results.

Keywords: Adipokine; Diabetes mellitus; Fibroblast growth factor 21; Gestational diabetes; Pregnancy

Core Tip: Fibroblast growth factor 21 (FGF21) plays a role in glucose and lipid metabolism, prompting studies on its potential as a predictive marker for gestational diabetes mellitus (GDM). This investigation examined serum FGF21 levels in the early second trimester and their association with GDM. Although a trend toward higher FGF21 levels was noted in insulin-treated GDM patients, no significant association was found between FGF21 and GDM status nor pregnancy outcomes. Possible reasons include a small sample size, low body mass index among participants, and unexamined factors like physical activity. Further research is needed to clarify the role of FGF21 in GDM.