Article Text
Abstract
Objective To examine the effects of dynamic change in fetuin-A levels before the diagnosis of gestational diabetes mellitus (GDM) on insulin resistance and GDM.
Research design and methods A total of 135 women with GDM and 135 normal glucose tolerance (NGT) women with matched age (±2 years old) and gestational age at taking the oral glucose tolerance test (OGTT) were included in this nested case–control study. Fasting venous blood samples were collected at the prenatal visit of the first trimester and during OGTT of the second trimester. Plasma concentration of fetuin-A and insulin was determined.
Results The plasma fetuin-A concentration in women with GDM was significantly higher than NGT controls in both the first trimester (medians: 403.0 pg/mL vs 273.4 pg/mL; p<0.05) and the second trimester (medians: 475.7 pg/mL vs 290.8 pg/mL; p<0.05) and notably increased from the first to the second trimester. Multivariate linear regression analysis showed that the change in fetuin-A concentration was associated with the changes in fasting insulin, homeostasis model assessment (HOMA) of insulin resistance, and HOMA of β-cell function (HOMA-β) (p<0.05). The highest quartile of the increase in fetuin-A concentration from the first to the second trimester was associated with a higher risk of developing GDM compared with the lowest quartile (OR 2.14; 95% CI 1.05 to 4.37).
Conclusions The dynamic change in fetuin-A levels was associated with the changes in insulin resistance and β-cell function from the first to the second trimester, and was associated with an increased risk of the development of GDM, indicating that fetuin-A could be a biomarker to predict the risk of GDM.
Trial registration number NCT03814395.
- gestational diabetes mellitus
- fetuin
- insulin resistance
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
Correction notice This article has been corrected since it was published. A co-corresponding author (Jue Liu) has been added.
Contributors CYJ, HJW and JL contributed to all aspects of the study design. NH and ZLZ coordinated the data collection. CYJ performed the data analysis and drafted the manuscript with input from LZL, ZL, SSL and XRX. All authors were involved in interpreting the data and critically reviewing the manuscript drafts. All authors gave approval for the final version of the manuscript. HJW and JL are the guarantors of this work and they had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This research was funded by the National Natural Science Foundation of China (grant number 81703240 and 81973053).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by the institutional review boards at Peking University (IRB00001052-18003).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. The data sets and deidentified participant data generated and analyzed during the current study are available from the corresponding author (HJW; ORCID identifier: 0000-0003-0849-2903) upon reasonable request.