Changes in Plasma Concentrations and mRNA Expression of Hepatokines Fetuin A, Fetuin B and FGF21 in Physiological Pregnancy and Gestational Diabetes Mellitus

Zheng

et al. 2020

BMJ Open Diab Res Care

ObjectiveFetuin-A is a glycoprotein produced by hepatocytes and has been associated with insulin resistance and bone growth in postnatal life. Gestational diabetes mellitus (GDM) is a condition characterized by insulin resistance. It is unclear whether GDM may affect cord blood fetuin-A levels and whether fetuin-A is associated with fetal growth.Research design and methodsIn a nested case–control study of 153 matched pairs of neonates of mothers with GDM and euglycemic pregnancies in the Shanghai Birth Cohort, we evaluated cord blood fetuin-A in association with GDM and fetal growth.ResultsComparing the newborns of GDM versus euglycemic mothers, cord blood fetuin-A concentrations were similar (mean±SD: 783.6±320.0 vs 754.8±281.9 µg/mL, p=0.53), while insulin-like growth factor (IGF)-I (76.6±27.8 ng/mL vs 68.1±25.1 ng/mL, p=0.008) and IGF-II (195.3±32.5 ng/mL vs 187.5±30.8 ng/mL, p=0.042) concentrations were higher. Cord blood fetuin-A was not correlated with insulin, IGF-I or IGF-II. Cord blood fetuin-A was negatively correlated with birth weight (r=−0.19, p=0.025) and birth length (r=−0.24, p=0.005) z scores in GDM pregnancies, while there were no significant correlations in euglycemic pregnancies (tests for interaction: p=0.014 for birth length, p=0.013 for birth length). Adjusting for maternal and neonatal characteristics, the differential associations remained.ConclusionsGDM was not associated with cord blood fetuin-A levels. Fetuin-A was negatively associated with fetal growth in GDM but not in euglycemic pregnancies. This novel observation suggests a GDM-conditional negative correlation of fetuin-A with fetal growth.

Section: Discussioncontrasting

confidence: 77%

Fetuin-A and fetal growth in gestational diabetes mellitus

Zheng

et al. 2020

BMJ Open Diab Res Care

Advanced Dental Journal

“…Sample size calculation was done based on the previous papers by Wang et al,2017 andŠimják et al,2018; that reported the difference in FGF-21 level between diabetic patients with periodontitis and healthy controls to be 100±70 pg/mL. 14 patients were needed to detect that difference using power 95% and 5% significance level.…”

Section: Sample Size Calculationmentioning

confidence: 99%

Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Amr

Mostafa

Shaker

2019

Background:The relation between diabetes mellitus and periodontitis has been discussed for years. Many adipokines were reported to play a major role in periodontal inflammation. Chemerin is one of these adipokines which is blamed to be involved in inflammatory conditions such as diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is believed to induce regulation of glucose. The current study aimed to spot the light on the potential role of gingival crevicular fluid (GCF) level of FGF21 and chemerin as biomarkers of periodontal disease activity and an attempt to understand their role in the link between periodontitis and diabetes. Methods: The study was conducted on 45 individuals, 15 diabetic patients with periodontitis, 15 periodontitis patients and 15 healthy controls. GCF samples were collected from all participants for assessment of chemerin and FGF 21. Samples were analysed using enzyme linked immunosorbent assay (ELISA). Results: Periodontitis patients with diabetes had significant higher levels of chemerin and FGF21 than the periodontitis patients without diabetes followed by healthy controls. ROC analysis showed a 100% diagnostic accuracy for chemerin and FGF21. Conclusion: FGF21 and chemerin in GCF are valuable biomarkers of periodontal disease suggesting a role in the link between diabetes and periodontitis.

“…Iyidir et al 12 also found that fetuin-A concentration between 24th and 28th gestational weeks significantly increased in 26 women with GDM compared with 24 healthy pregnant women. However, Kralisch et al ,15 Simjak et al ,16 and Farhan et al 11 found that fetuin-A levels did not differ between women with GDM and without at 28th, 29th and 28th–38th gestational weeks, respectively. Another previous study evaluated fetuin-A levels in the first trimester (11–14 gestational weeks), and lower fetuin-A levels were found in 29 women with GDM as compared with 59 healthy pregnant women 14.…”

Section: Discussionmentioning

confidence: 97%

“…Considering GDM shared the similar pathophysiological feature of insulin resistance with T2DM, and women with GDM were at high risk of developing T2DM in later life,10 it could be speculated that fetuin-A might also be an important biomarker involved in the pathogenesis of GDM development. However, so far, limited research on the correlation between fetuin-A and GDM yielded inconsistent findings 11–16. Some of them found significant differences in fetuin-A concentration between healthy pregnant and GDM group,12–14 while others did not 11 15 16.…”

Section: Introductionmentioning

confidence: 99%

“…However, so far, limited research on the correlation between fetuin-A and GDM yielded inconsistent findings 11–16. Some of them found significant differences in fetuin-A concentration between healthy pregnant and GDM group,12–14 while others did not 11 15 16. Previous studies were mainly limited by relatively small sample size and most of them measured fetuin-A concentration at or after the time of diagnosis of GDM.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of dynamic change in fetuin-A levels from the first to the second trimester on insulin resistance and gestational diabetes mellitus: a nested case–control study

Jin

Lin

Han

et al. 2020

BMJ Open Diab Res Care

ObjectiveTo examine the effects of dynamic change in fetuin-A levels before the diagnosis of gestational diabetes mellitus (GDM) on insulin resistance and GDM.Research design and methodsA total of 135 women with GDM and 135 normal glucose tolerance (NGT) women with matched age (±2 years old) and gestational age at taking the oral glucose tolerance test (OGTT) were included in this nested case–control study. Fasting venous blood samples were collected at the prenatal visit of the first trimester and during OGTT of the second trimester. Plasma concentration of fetuin-A and insulin was determined.ResultsThe plasma fetuin-A concentration in women with GDM was significantly higher than NGT controls in both the first trimester (medians: 403.0 pg/mL vs 273.4 pg/mL; p<0.05) and the second trimester (medians: 475.7 pg/mL vs 290.8 pg/mL; p<0.05) and notably increased from the first to the second trimester. Multivariate linear regression analysis showed that the change in fetuin-A concentration was associated with the changes in fasting insulin, homeostasis model assessment (HOMA) of insulin resistance, and HOMA of β-cell function (HOMA-β) (p<0.05). The highest quartile of the increase in fetuin-A concentration from the first to the second trimester was associated with a higher risk of developing GDM compared with the lowest quartile (OR 2.14; 95% CI 1.05 to 4.37).ConclusionsThe dynamic change in fetuin-A levels was associated with the changes in insulin resistance and β-cell function from the first to the second trimester, and was associated with an increased risk of the development of GDM, indicating that fetuin-A could be a biomarker to predict the risk of GDM.Trial registration numberNCT03814395.