Is fibroblast growth factor 23 a new cardiovascular risk marker in gestational diabetes?

ABSTRACT Objective This study was designed to compare the serum levels of fibroblast growth factor 23 (FGF23) among patients with gestational diabetes mellitus (GDM) and healthy pregnant women, and to evaluate the association between hormonal and metabolic parameters. Subjects and methods A total of 82 pregnant women were consecutively enrolled in the study. Of these, 46 were diagnosed as having GDM; the remaining 36 healthy pregnant women served as controls in a cross-sectional study design. The womens’ ages ranged from 22 to 38 years and gestational ages, from 24 to 28 weeks. Serum samples were analyzed for FGF23 levels using an enzyme-linked immunosorbent assay. Results Serum FGF23 levels were increased in patients with GDM compared with controls (median, 65.3 for patients with GDM vs. 36.6 ng/mL for healthy controls; p = 0.019). Mean fasting glucose (105.6 ± 7.4 vs. 70.2 ± 7.2 mg/dL, p < 0.001), HbA1c (5.6 ± 0.5 vs. 4.9 ± 0.5%, p < 0.001), insulin (median, 11.1 vs. 8.7 µIU/mL, p = 0.006) and HOMA-IR (3.0 (1.8) vs 1.4 (0.6), p < 0.001) levels were significantly higher in patients with GDM than in controls. Serum FGF23 level was positively correlated with body mass index (r2 = 0.346, p < 0.05), FPG (r2 = 0.264, p < 0.05), insulin (r2 = 0.388, p < 0.05), HOMA-IR (r2 = 0.384, p < 0.05). Conclusion Serum FGF23 levels were higher in women with GDM compared with controls. The present findings suggest that FGF23 could be a useful marker of cardiovascular disease in GDM.

【摘要】目的 本研究旨在比较妊娠糖尿病（gestational diabetes mellitus, GDM）患者与健康妊娠女性的血清成纤维细胞生长因子23（fibroblast growth factor 23, FGF23）水平，并评估激素与代谢参数间的关联。对象与方法 本研究采用横断面研究设计，连续纳入82名妊娠女性，其中46例被诊断为GDM，剩余36例健康妊娠女性作为对照。受试者年龄为22~38岁，孕周为24~28周。采用酶联免疫吸附试验（enzyme-linked immunosorbent assay）检测血清FGF23水平。结果 与对照组相比，GDM患者的血清FGF23水平显著升高（中位数：GDM组65.3 ng/mL，健康对照组36.6 ng/mL；p=0.019）。GDM患者的空腹血糖（fasting plasma glucose, FPG）均值（105.6±7.4 vs 70.2±7.2 mg/dL，p<0.001）、糖化血红蛋白（HbA1c）均值（5.6±0.5 vs 4.9±0.5%，p<0.001）、胰岛素中位数（11.1 vs 8.7 µIU/mL，p=0.006）以及胰岛素抵抗稳态模型评估（HOMA-IR）值[3.0(1.8) vs 1.4(0.6)，p<0.001]均显著高于对照组。血清FGF23水平与体重指数（body mass index, BMI，r²=0.346，p<0.05）、FPG（r²=0.264，p<0.05）、胰岛素（r²=0.388，p<0.05）及HOMA-IR（r²=0.384，p<0.05）呈正相关。结论 与健康妊娠女性相比，GDM患者的血清FGF23水平更高。本研究结果提示，FGF23或可作为GDM患者心血管疾病的潜在生物标志物。