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Am J Perinatol 2021; 38(13): 1380-1385
DOI: 10.1055/s-0040-1712966
Original Article

Fibroblast Growth Factor 21 and Metabolic Dysfunction in Women with a Prior Glucose-Intolerant Pregnancy

Celeste Durnwald
1   Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
,
Lisa Mele
2   George Washington University Biostatistics Center, Washington, District of Columbia
,
Mark B. Landon
3   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Michael W. Varner
4   Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
,
Brian M. Casey
5   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Uma M. Reddy
6   Eunice Kennedy Shriver National Institute of Child Health and Human Development (U.M.R.), Bethesda, Maryland
,
Ronald J. Wapner
7   Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Dwight J. Rouse
8   Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island
,
Alan T. N. Tita
9   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
John M. Thorp Jr.
10   Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Edward K. Chien
11   Department of Obstetrics and Gynecology, MetroHealth Medical Center – Case Western Reserve University, Cleveland, Ohio
,
George R. Saade
12   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Alan M. Peaceman
13   Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
,
Sean C. Blackwell
14   Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas
,
for the Eunice Kennedy Shriver National Institute of Child Health Human Development (NICHD) Maternal Fetal Medicine Units (MFMU) Network› Author Affiliations
Funding This study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant numbers: HD27915, HD36801, HD34208, HD34116, HD40485, HD40500, HD27869, HD40560, HD40544, HD53097, HD40512, and HD40545) and the National Institutes of Health's National Center for Advancing Translational Sciences (grant numbers: UL1TR001070 and UL1TR000439). Comments and views of the authors do not necessarily represent views of the National Institutes of Health.
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Abstract

Objective We sought to determine if there is an association between fibroblast growth factor 21 (FGF21) levels and a history of gestational diabetes mellitus (GDM) in women with and without metabolic dysfunction, defined as a diagnosis of metabolic syndrome or type 2 diabetes (T2DM), 5 to 10 years following participation in a multiple cohort GDM study.

Study Design At 5 to 10 years after index pregnancy, women underwent a follow-up visit and were categorized as having no metabolic syndrome, metabolic syndrome, or T2DM. FGF21 levels were compared between women who did and did not have a history of GDM using multivariable linear regression.

Results Among 1,889 women, 950 underwent follow-up and 796 had plasma samples analyzed (413 GDM and 383 non-GDM). Total 30.7% of women had been diagnosed with T2DM or metabolic syndrome. Overall, there was no difference in median FGF21 levels in pg/mL between the prior GDM and non-GDM groups (p = 0.12), and the lack of association was observed across all three metabolic categories at follow-up (p for interaction = 0.70).

Conclusion There was no association between FGF21 levels and prior history of mild GDM in women with and without metabolic dysfunction 5 to 10 years after the index pregnancy (ClinicalTrials.gov number, NCT00069576, original trial).

Keywords

fibroblast growth factor - gestational diabetes - glucose intolerance - metabolic syndrome

Note

This study was presented in part at the 2018 Annual Scientific Meeting of the Society for Maternal–Fetal Medicine (January 29 to February 3, 2017), Dallas, TX.


* See [Supplementary Material] (available in the online version) for list of other members of the NICHD MFMU Network, Bethesda, MD.


Supplementary Material



Publication History

Received: 20 May 2019

Accepted: 28 April 2020

Article published online:
23 June 2020

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