Fibroblast growth factor‑21 is a potential diagnostic factor for patients with gestational diabetes mellitus

Abstract

Gestational diabetes mellitus (GDM) is a metabolic disease with symptoms of hyperglycemia, insulin resistance and fetal maldevelopment. Evidence has indicated that fibroblast growth factor (FGF)-21 is a multifunctional protein and exhibits potential therapeutic value for metabolic diseases. The present study investigated the diagnostic value of FGF-21 serum levels in patients with GDM (n=50) and age-matched healthy individuals (n=50). It was demonstrated that the gene and protein expression levels of FGF-21 were downregulated in adipose cells in patients with GDM compared with those in healthy individuals. The results also indicated that the serum levels of FGF-21 were downregulated in patients with GDM compared with those in healthy individuals. In addition, it was demonstrated that blood glucose and blood pressure were higher in patients with GDM compared with those in healthy individuals. GDM patients had a markedly higher insulin resistance and glucose tolerance than healthy individuals. However, GDM patients had significantly lower serum levels of insulin than healthy individuals. It was observed that the serum levels of FGF-21 were positively correlated with those of glucose in GDM patients. In conclusion, these results indicate that decreased FGF-21 levels are associated with the risk of GDM, suggesting that FGF-21 may be a potential diagnostic factor for GDM.

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

“…FGF21 stimulates glucose uptake and thermogenesis in BAT whilst in WAT it attenuates lipolysis and increases glucose uptake and adiponectin secretion. 55 On the contrary, a recent study by Xu C et al 57 involving 100 subjects reported that serum FGF21 levels were lower in patients with GDM compared to those in healthy individuals. In the pancreas, FGF21 enhances β cell survival and improves glucose-stimulated insulin secretion.…”

“…However, further studies are needed to elucidate the basis of elevated FGF21 levels in GDM and whether FGF21 resistance exists in GDM. 55 On the contrary, a recent study by Xu C et al 57 involving 100 subjects reported that serum FGF21 levels were lower in patients with GDM compared to those in healthy individuals. However, in that study, the control group was not pregnant, which was a major limitation.…”

Novel Biomolecules in the Pathogenesis of Gestational Diabetes Mellitus

“…However, it may not be a major factor in the pathogenesis of GDM [ 164 ]. In addition, reduced serum FGF21 levels in GDM patients were shown by Xu et al [ 165 ]. However, a major limitation of this study is that the control group was not pregnant, so it cannot be compared to previous studies.…”

Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases

“…The sensitivity could have been limited by the variability and quality of samples and detection method, and specificity could have decreased since most biomarkers point out common diabesogenic processes (i.e., insulin resistance, inflammation). In this regard, FGF-21 [148, 169], visfatin [127, 170], IL-6 [119, 171] and resistin [128, 129] displayed variable levels depending on pregnancy phase, and afamin, among others, could serve also as a valid biomarker for other complicated pregnancies, like those with preeclampsia [149]. In this line, GDM patients with cardiovascular risk could be classified by testing biomarkers with key roles on cardiovascular pathophysiology.…”