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First-Trimester Serum Fatty Acid-Binding Protein 4 and Subsequent Gestational Diabetes Mellitus

Tu, Wen-Jun MD, PhD; Guo, Min MD; Shi, Xiao-Dong MD; Cai, Yan MD; Liu, Qiang PhD; Fu, Chen-Wei MD, PhD

doi: 10.1097/AOG.0000000000002310
Contents: Original Research

OBJECTIVE: To examine whether plasma fatty acid-binding protein 4 concentrations, measured in the first trimester, are associated with gestational diabetes mellitus (GDM).

METHODS: This prospective, multicenter cohort study was conducted at three maternity centers in two cities (Harbin and Beijing) in China from July 2015 to June 2016. Data for fasting plasma glucose and fatty acid-binding protein 4 concentrations in the first trimester and one-step GDM screening with a 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were collected and analyzed.

RESULTS: Plasma from women in the first trimester was available for 1,150 women, of whom 135 (11.7%) developed GDM. The GDM distribution across the fatty acid-binding protein 4 quartiles ranged from 3.8% (first quartile) to 21.6% (fourth quartile). In multivariate models comparing the second (quartile 2), third, and fourth quartiles against the first quartile of fatty acid-binding protein 4, concentrations of fatty acid-binding protein 4 in quartile 2, quartile 3, and quartile 4 were associated with the development of GDM with respective associated adjusted odds ratios (95% CIs) of 1.76 (1.21–2.58), 2.36 (1.55–4.29), and 3.57 (1.99–6.11). A significant difference in the area under receiver operating characteristic curve between established risk factors alone and the addition of fatty acid-binding protein 4 concentrations was observed (difference 0.042 [95% CI 0.028–0.055]; P=.03).

CONCLUSIONS: Higher fatty acid-binding protein 4 concentrations in the first trimester visit were associated with increased risk of GDM and might be useful in identifying women at risk for GDM for early prevention strategies.

Plasma concentration of fatty acid-binding protein 4 in the first trimester is positively associated with the development of gestational diabetes mellitus in a Chinese population.

Institute of Radiation Medicine, China Academy of Medical Science & Peking Union Medical College, Tianjin, the Department of Laboratory, China Rehabilitation Research Center, Beijing, the Departments of Endocrinology and Gynaecology and Obstetrics, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, and the Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Beijing, China.

Corresponding author: Qiang Liu, PhD, No. 238, Baiti Road, Tianjin 300192, PR China; email: liuqiang_cams@163.com.

Supported by the CAMS Innovation Fund for Medical Science (No. 2017-I2M-1–021) and National Natural Science Foundation of Heilongjiang.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank the nurses, physicians, and patients who participated in our study and the staff of the central laboratories of the hospitals.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.