Fibroblast growth factor 21 expressions in white blood cells and sera of patients with gestational diabetes mellitus during gestation and postpartum

Abstract

Fibroblast growth factor 21 (FGF21), a recently discovered regulatory factor, plays an important role in glucose and lipid metabolism. In this study, we firstly found the FGF21 expression in white blood cells (WBCs). Then, we enrolled 51 women with gestational diabetes mellitus (GDM) and 50 pregnant women with normal blood glucose levels to determine the FGF21 levels in the WBCs and the sera at the 28th week of pregnancy, and tracked the dynamic changes of FGF21 in these women until the 7th day postpartum. Repeated Measures analysis of variance (ANOVA) revealed that there was a significant interaction effect between group and time on FGF21 levels (P < 0.05). FGF21 levels were significantly higher in the GDM patients than those in the controls at the 28th week of pregnancy. The 7th day after the delivery, the FGF21 levels decreased in the WBCs and the sera in both groups. The D values (the difference between pregnancy and postpartum) for FGF21 levels were significantly higher in the GDM group (P < 0.05). Serum FGF21 level during gestation positively correlated with leptin, triglyceride, and HDL-cholesterol, and FGF21 may act as a glucose and lipid metabolism compensatory regulatory factor to improve glucose and lipid metabolism during the period of pregnancy. Further, FGF21 level in the WBCs (during pregnancy and the D values for FGF21) was chiefly influenced by GDM.

Role of fibroblast growth factor 21 in gestational diabetes mellitus: A mini‐review

“…25 A similar study of 90 pregnant women of Chinese ethnicity also revealed that serum FGF21 levels were higher in patients with GDM (median: 125 pg/mL; IQR 83-190) compared to controls (median 68 pg/mL; IQR 49-98 pg/mL; P < 0.001). 25 A similar study of 90 pregnant women of Chinese ethnicity also revealed that serum FGF21 levels were higher in patients with GDM (median: 125 pg/mL; IQR 83-190) compared to controls (median 68 pg/mL; IQR 49-98 pg/mL; P < 0.001).…”

“…A study of 101 pregnant women of north-eastern Chinese ethnicity at the 28th week of gestation found significantly higher serum FGF21 levels among women with GDM than in controls matched for gestational age and weight (400 ± 128 ng/L vs 248 ± 107ng/L, P < 0.01). 25 A similar study of 90 pregnant women of Chinese ethnicity also revealed that serum FGF21 levels were higher in patients with GDM (median: 125 pg/mL; IQR 83-190) compared to controls (median 68 pg/mL; IQR 49-98 pg/mL; P < 0.001). 24 Based on previous studies on the role of FGF21 in different metabolic diseases with similar pathophysiological mechanisms to GDM, it can be speculated that this upregulation of FGF21 may be a compensatory mechanism for the underlying insulin resistance in order to increase whole-body F I G U R E 2 Mechanisms by which FGF21 improves glycaemic control in mouse and in vitro cell culture models.…”

“…15,21,[23][24][25][26][27][28] This review aims to synthesize data from original research on FGF21 levels in patients with GDM in order to guide future research directions and to explore the therapeutic potential of FGF21 in GDM. 15,21,[23][24][25][26][27][28] This review aims to synthesize data from original research on FGF21 levels in patients with GDM in order to guide future research directions and to explore the therapeutic potential of FGF21 in GDM.…”

“…There are a limited number of studies investigating circulating levels of FGF21 in patients with GDM compared to those without. 15,21,[23][24][25][26][27][28] This review aims to synthesize data from original research on FGF21 levels in patients with GDM in order to guide future research directions and to explore the therapeutic potential of FGF21 in GDM.…”

“…detected in the placentae of women with GDM relative to normoglycaemic women in the study by Nitert et al15 Furthermore, in the study by Li et al25 , FGF21 levels were tracked until the 7th day post-partum by which time glucose levels in the GDM group had returned to normal, and FGF21 levels had decreased significantly in both the GDM and NGT patients. With reports of the placenta being an important organ for expression of FGF21, and potentially increased expression of FGF21 levels in GDM patients, it can be speculated that placental FGF21 may enter the maternal circulation in pregnant women with GDM thereby increasing circulating FGF21 15,25. Despite the positive findings from the study of Nitert et al,15 data on FGF21 expression in the placenta are discordant.…”