Diabetologie und Stoffwechsel 2009; 4 - P_107
DOI: 10.1055/s-0029-1221912

Serum FGF21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia

T Ebert 1, S Stein 1, H Stepan 2, J Kratzsch 3, M Verlohren 4, HJ Verlohren 4, K Drynda 5, U Lössner 1, M Blüher 1, M Stumvoll 1, M Fasshauer 1, 6
  • 1University of Leipzig, Department of Internal Medicine III, Leipzig, Germany
  • 2University of Leipzig, Department of Obstetrics, Leipzig, Germany
  • 3University of Leipzig, Institute of Laboratory Medicine, Leipzig, Germany
  • 4Outpatient Care Unit, 04177, Leipzig, Germany
  • 5Outpatient Care Unit, 04103, Leipzig, Germany
  • 6Interdisciplinary Center for Clinical Research (IZKF), Leipzig, Germany

Background: Fibroblast growth factor 21 (FGF21) was recently introduced as a novel adipokine with beneficial effects on glucose homeostasis and insulin sensitivity. In contrast to other adipokines including adiponectin and leptin, concentrations of circulating FGF21 have not been evaluated so far in gestational diabetes mellitus (GDM). In the current study, we investigated serum concentrations of FGF21 in patients with GDM as compared to healthy pregnant controls matched for gestational age and fasting insulin.

Methods: FGF21 was determined by ELISA 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.

Results: Median maternal serum FGF21 concentrations were not significantly different in subjects with GDM (97.5ng/l) as compared to healthy pregnant controls (102.9ng/l). FGF21 significantly and positively correlated with markers of insulin resistance (increased homeostasis model assessment of insulin resistance [HOMA-IR], 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 HOMA-IR.

Conclusions: FGF21 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.