Serum Fibroblast Growth Factor 21 Levels in Gestational Diabetes Mellitus in Relation to Insulin Resistance and Dyslipidemia

Fibroblast growth factor 21 (FGF21) has beneficial effects on glucose homeostasis and insulin sensitivity. In the current study, we investigated serum concentrations of FGF21 in patients with gestational diabetes mellitus (GDM) as compared with healthy pregnant controls matched for gestational age and fasting insulin. Fibroblast growth factor 21 was determined by enzyme-linked immunosorbent assay in control (n = 80) and GDM (n = 40) patients and correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation in both groups. Median maternal serum FGF21 concentrations were not significantly different in subjects with GDM (97.5 ng/L) as compared with healthy pregnant controls (102.9 ng/L). Fibroblast growth factor 21 significantly and positively correlated with markers of insulin resistance (increased homeostasis model assessment of insulin resistance, decreased adiponectin) and dyslipidemia (increased triglycerides, decreased high-density lipoprotein cholesterol) in univariate and multivariate analyses. Furthermore, FGF21 serum levels were highest in patients in the third tertile of homeostasis model assessment of insulin resistance. Fibroblast growth factor 21 is independently associated with markers of insulin resistance and an adverse lipid profile but is not dysregulated in GDM if patients are matched with controls for fasting insulin.