Fibroblast Growth Factors 19 and 21 in Gestational Diabetes Mellitus

First，30 pregnant women with GDM and 60 pregnant control women with normal glucose tolerance (NGT) matched for maternal and gestational age were enrolled in the study. All the subjects underwent antepartum screening in the First Affiliated Hospital of Sun Yat-sen University. Blood samples were obtained after overnight fasting at the time of oral glucose tolerance test (OGTT). Serum FGF19 and FGF21 levels were determined by enzyme-linked immunosorbent assay (ELISA) and were correlated with anthropometric, metabolic, and endocrine parameters. Homeostasis model assessment (HOMA-IR) index was calculated and analysed.

Second, samples for measurement were obtained from 30 women with GDM and 35 healthy pregnant controls undergoing caesarean sections at term. mRNA and protein expression levels of FGF19/FGF21 and their co-receptor βKlotho（KLB）in placenta, rectus muscle and subcutaneous fat tissues were investigated with real-time quantitative polymerase chain reaction (qRT-PCR), western-blot and immunohistochemistry (IHC), respectively. Clinical data were collected and analysed.

Data were analyzed by SPSS 20.0 database. The results were expressed as mean ± standard deviations or median with interquartile range. Differences between groups were assessed by Student's unpaired t test, Mann-Whitney U test, or Chi-square test as appropriate. Correlation analysis was performed using the Spearman rank correlation method. To identify independent relationships and adjust the effects of covariates, multiple linear regression analyses were performed. P values of <0.05 were considered significant.

Inclusion criteria

• Women with singleton pregnancy;
• Regular antenatal examination from the first trimester;
• Give birth in the university hospital (The 1st affiliated hospital of Sun Yat-sen University)

Exclusion criteria

• Younger than 18 years old;
• Older than 40 years old;
• Multiple pregnancy;
• Diagnosed DM before pregnancy;
• Complicated with other diseases such as hypertension, eclampsia, thyroid diseases, etc.;
• Taking any drug that affect glucose and lipid metabolism and insulin sensitivity.