Fibroblast Growth Factor 19 in Gestational Diabetes Mellitus and Fetal Growth

Abstract

Fibroblast growth factor 19 (FGF19) has been implicated in glucose homeostasis. Gestational diabetes mellitus (GDM) enhances fetal insulin secretion and fetal growth. Girls weigh less and are more insulin resistant than boys at birth. We sought to assess whether FGF19 is associated with GDM and fetal growth and explore potential sex dimorphic associations. This was a nested case-control study in the Shanghai Birth Cohort, including 153 pairs of newborns of GDM versus euglycemic mothers matched by infant’s sex and gestational age at birth. Cord plasma FGF19, insulin, C-peptide, proinsulin, IGF-I and IGF-II concentrations were measured. Cord plasma FGF19 concentrations were similar in GDM versus euglycemic pregnancies (mean ± SD: 43.5 ± 28.2 versus 44.5 ± 30.2 pg/mL, P=0.38). FGF19 was not correlated with IGF-I or IGF-II. FGF19 concentrations were positively correlated with birth weight (r=0.23, P=0.01) and length (r=0.21, P=0.02) z scores, C-peptide (r=0.27, P=0.002) and proinsulin (r=0.27, P=0.002) concentrations in females. Each SD increment in cord plasma FGF19 was associated with a 0.25 (0.07-0.43) increase in birth weight z score in females. In contrast, FGF19 was not correlated with birth weight or length in males. These sex dimorphic associations remained after adjusting for maternal and neonatal characteristics. The study is the first to demonstrate that GDM does not matter for cord blood FGF19 concentrations. The female specific positive correlation between FGF19 and birth weight is suggestive of a sex-dimorphic role of FGF19 in fetal growth. The observations call for more studies to validate the novel findings and elucidate the underlying mechanisms.

Adiponectin, A-FABP and FGF-19 Levels in Women with Early Diagnosed Gestational Diabetes

“…There was also reduced placental and muscular expression of FGF-19 in women with GDM after delivery [33]. In contrast, a recent study found plasma concentrations of FGF-19 in the umbilical cord similar to those in healthy pregnant controls, suggesting that GDM does not affect fetal FGF-19 levels [34]. Wang et al also demonstrated an independent and inverse association between FGF-19 and insulin resistance in GDM [32].…”

The Role of the FGF19 Family in the Pathogenesis of Gestational Diabetes: A Narrative Review

“…FGF19 levels were higher in newborns born by cesarean section than those born by vaginal delivery. FGF19 was positively correlated with neonatal size only in female newborns, suggesting a sex-specific effect of FGF19 on fetal growth [129]. The study by Karasek et al showed that when gestational diabetes is diagnosed early (8-14 weeks), FGF19 concentrations do not differ significantly between diabetic and healthy pregnant women throughout pregnancy.…”