Circulating FABP4, nesfatin-1, and osteocalcin concentrations in women with gestational diabetes mellitus: a meta-analysis

Abstract

Objective: Recent studies have investigated the circulating adipocyte fatty acid binding protein (FABP4), nesfatin-1, and osteocalcin (OC) concentrations in women diagnosed with gestational diabetes mellitus (GDM), but the findings prove to be conflicting. The objective of this research was to systematically assess the relationship of circulating levels of above adipokines with GDM. Methods: Pubmed, Embase, Web of Science, Cochrane library, OVID, and Scopus were performed to locate articles published up to January 31, 2020. Pooled standard mean differences (SMDs) with 95% confidence intervals (CIs), and 95% predictive intervals (PIs) were calculated by random-effects models to compare levels of adipokines between GDM cases and control groups. Cumulative and single-arm meta-analyses were also performed. Results: Thirty-one studies comprising 4590 participants were included. No significant differences were found between GDM women and healthy controls in circulating nesfatin-1 levels (4.56 vs. 5.02 ng/mL; SMD = − 0.11, 95% CI-0.61-0.38, 95% PI-1.63-1.41). Nevertheless, circulating FABP4 and OC levels observed in GDM women outnumbered normal controls (FABP4, 23.68 vs. 16.04 ng/mL; SMD = 2.99, 95% CI 2.28-3.69, 95% PI 0.28-5.71; OC, 52.34 vs. 51.04 ng/mL; SMD = 0.68, 95% CI 0.31-1.05, 95% PI-0.48-1.84). The cumulative meta-analysis showed that the SMDs of circulating FABP4 and OC levels had stabilized between the two groups. Conclusions: Elevated circulating FABP4 and OC levels were observed in GDM women, but nesfatin-1 levels did not change, the PI of OC crossed the no-effect threshold. The results suggested that FABP4 is more suitable as a biomarker of GDM compared to OC in a future study, which is useful in identifying pregnant women who are likely to develop GDM and providing prompt management strategies.

Novel Biomolecules in the Pathogenesis of Gestational Diabetes Mellitus

“…This molecule can be detected in small amounts in blood and used as a marker of osteogenesis [ 78 ]. Three forms of osteocalcin: carboxylated (cOC), under-carboxylated (ucOC), total osteocalcin (tOC) may be distinguished [ 79 ]. cOC seems to be involved in osteogenesis and influences osteoclast maturation.…”

“…A meta-analysis by Sun et al included seven studies of plasma OC concentrations in pregnant women [ 79 ]. A total of 628 had GDM, and 612 were healthy.…”

Maternal Serum Delta-Like 1 and Nesfatin-1 Levels in Gestational Diabetes Mellitus: A Prospective Case-Control Study

“…It has been revealed in a meta-analysis that these conflicting results might be due to the differences in the geographical region and the applied diagnostic criteria. For instance, whereas nesfatin-1 was detected at lower levels in Caucasian pregnant women with GDM, it was found similar to healthy pregnant women in Asian pregnant women with GDM [29]. Moreover, whereas the concentrations of nesfatin-1 in the circulation in women diagnosed with GDM according to Coustan and Carpenter (C&C) and WHO criteria were lower than controls, it was determined higher in pregnant women with GDM diagnosed in accordance with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria compared to the control group [29].…”

“…For instance, whereas nesfatin-1 was detected at lower levels in Caucasian pregnant women with GDM, it was found similar to healthy pregnant women in Asian pregnant women with GDM [29]. Moreover, whereas the concentrations of nesfatin-1 in the circulation in women diagnosed with GDM according to Coustan and Carpenter (C&C) and WHO criteria were lower than controls, it was determined higher in pregnant women with GDM diagnosed in accordance with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria compared to the control group [29]. Nesfatin-1, which is directly related to appetite, might play a role in regulating body weight in pregnant women, albeit the effects of nesfatin-1 on the underlying pathogenesis of GDM are not entirely figured out.…”

Adipose-Derived Lipid-Binding Proteins: The Good, the Bad and the Metabolic Diseases

“…In humans, serum levels of FABP4 are higher in obese, type 1 diabetic, type 2 diabetic and gestational diabetic individuals compared to non-obese, non-diabetic subjects [ 34 , 35 , 36 , 37 ]. Gastric bypass surgery reduces circulating FABP4 by 42% in obese patients with type 2 diabetes, whereas behavioral and nutritional intervention alone does not reduce the serum levels of FABP4 [ 35 ].…”