Fatty acid-binding protein 4 predicts gestational hypertension and preeclampsia in women with gestational diabetes mellitus

Abstract

ObjectiveFatty acid-binding protein 4 (FABP4) has been proposed to be a potential predictive factor of gestational hypertension or preeclampsia (GH/PE) because of its integrating metabolic and inflammatory responses. Women with gestational diabetes mellitus (GDM) are more likely to develop both GH/PE, than the normal population. The aim of our study was to examine the relationship between plasma FABP4 in the second trimester of pregnancy and the risk of GH/PE in women with GDM.MethodsThis was a nested case-control study conducted within a large on-going prospective cohort study conducted at Peking University First Hospital. A total of 1344 women, who were diagnosed with GDM, according to a 75 g oral glucose tolerance test, participated in the GDM One-Day Clinic at Peking University First Hospital from February 24, 2016 to February 9, 2017. Of the 748 GDM women who agreed to the blood sample collection, 637 were followed until their delivery. The cases included GDM patients who developed gestational hypertension or preeclampsia (GDM-GH/PE group, n = 41). Another 41 matched GDM women without major complications were selected as the control group (GDM group).ResultsThe incidence of GH/PE was 6.44% and 3.30% for preeclampsia. The level of the second trimester plasma FABP4 in the GDM-GH/PE group was significantly higher than the GDM group (17.53±11.35 vs. 12.79±6.04 ng/ml, P = 0.020). The AUC ROC for the second trimester plasma FABP4 predicted GH/PE in the GDM patients alone was 0.647 (95%CI 0.529–0.766). Multivariate analysis showed that the elevated second trimester FABP4 level was independently associated with GH/PE in the GDM patients (OR 1.136 [95% CI 1.003–1.286], P = 0.045).ConclusionsIncreased second trimester plasma FABP4 independently predicted GH/PE in GDM patients.

Associations between Fatty Acid-Binding Protein 4–A Proinflammatory Adipokine and Insulin Resistance, Gestational and Type 2 Diabetes Mellitus

“…Abnormalities in the level of FABP4 have been correlated with the development of adiposity, oxidative stress, and atherosclerosis [40]. FABP4 is strongly involved in glucose and lipid metabolism, inflammation, and insulin resistance [76]. In one of the most recent systematic reviews by Bellos et al, targeting the potential association of 10 novel adipokines (i.e., apelin, chemerin, FABP4, fibroblast growth factor-1, monocyte chemoattractant protein-1, nesfatin-1, omentin-1, resistin, vaspin, and visfatin) with GDM, only FABP4 was found to be the most promising predictor of this metabolic pregnancy complication [99].…”

“…Furthermore, several studies have shown that serum FABP4 levels of GDM patients were higher than those found in women with normal pregnancies [30,65,73,76]. According to the current state of scientific knowledge, females with a previous history of GDM are much more prone to suffering from T2DM, obesity, and metabolic syndrome in the future.…”

“…It has also been reported that maternal FABP4 levels are elevated in preeclampsia, even before the clinical onset of the disease [11]. The level of the second trimester plasma FABP4 in the preeclampsia GDM group was significantly higher than that of the patients with only GDM [76]. Besides, Wotherspoon et al [77] revealed that increased second-trimester FABP4 levels independently predicted pre-eclampsia in women with type 1 diabetes mellitus.…”

The Association Between Trimester-Specific Weight Gain and Severe Preeclampsia/Adverse Perinatal Outcome in Gestational Diabetes Mellitus Complicated by Preeclampsia: A Retrospective Case Study

“…The incidence of GDM complicated by preeclampsia is unclear. According to the diagnostic criteria of the Ministry of Health (MOH) in China, the prevalence of GDM is 17.5% [ 13 ], and another study reports that the prevalence of preeclampsia among patients with GDM in China is 3.3% [ 14 ]. On the basis of the above results, it is estimated that the incidence of GDM combined with preeclampsia in China is 0.57% approximately.…”

Screening of differentially expressed proteins from syncytiotrophoblast for severe early-onset preeclampsia in women with gestational diabetes mellitus using tandem mass tag quantitative proteomics

“…These studies partly revealed the potential pathogenesis of PE and identified candidate biomarkers to predict the occurrence of PE during pregnancy. Li et al found that the level of plasma fatty acid-binding protein 4 (FABP4) in patients with PE in the GDM group was significantly higher than that in the GDM group, suggesting that plasma FABP4 level could predict the occurrence of PE in women with GDM [ 20 ]. However, no studies using high-throughput proteomic analysis to screen differentially expressed proteins between patients with GDM and patients with GDM with subsequently developed PE have been conducted.…”