Abstract

Objective The study is aimed at examining the effects of fatty acid-binding protein 4 (FABP4) on insulin resistance and gestational diabetes mellitus (GDM). Methods Based on a prospective birth cohort in Beijing, China, we conducted a nested case-control study and analyzed 135 GDM case-control pairs matched by age and the gestational week when they took the oral glucose tolerance test. We performed linear regression to analyze the association of plasma FABP4 concentrations with insulin resistance. We used logistic regression to estimate odds ratios (ORs) of FABP4 for GDM, controlling for potential confounders, including dietary intake and physical activity. Results Plasma FABP4 levels in the first and second trimesters were positively associated with fasting insulin and homeostasis model assessment for insulin resistance (HOMA-IR) in the second trimester (both P < 0.001). Compared with those in the lowest FABP4 tertile, women in the highest tertile of FABP4 levels in the first and second trimesters had 1.053 times (OR = 2.053, 95% CI 1.091 to 3.863) and 1.447 times (OR = 2.447, 95% CI 1.305 to 4.588) higher risk of developing GDM. Conclusions Elevated FABP4 levels in the first and second trimesters were associated with a higher level of insulin resistance and greater GDM risk, indicating FABP4 might predict women with high risk of developing GDM.

Highlights

  • Gestational diabetes mellitus (GDM) is an increasing public health concern, affecting 2% to 25% of pregnancies worldwide [1]

  • We found no differences in maternal age, gestational week at enrollment, parity, education, prepregnancy body mass index (BMI), Gestational weight gain (GWG) before oral glucose tolerance test (OGTT), physical activity, dietary intake, SBP, DBP, triglyceride, highdensity lipoprotein (HDL) cholesterol, alanine transaminase (ALT), and AST between two groups

  • In the nested case-control study, we found that increased fatty acid-binding protein 4 (FABP4) concentrations in the first and second trimesters were associated with a greater risk of developing GDM

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Summary

Introduction

Gestational diabetes mellitus (GDM) is an increasing public health concern, affecting 2% to 25% of pregnancies worldwide [1]. It was estimated in 2019 that globally 17.1 million women with live births had GDM in pregnancy [2]. Four studies analyzed the levels of FABP4 in the first trimester and yielded inconsistent results [17,18,19,20] They were either limited by not adjusting for some important lifestyle factors associated with GDM, such as dietary intake and physical activity [17, 19, 20], or measuring

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