Correlations of serum glucose-dependent insulin releasing peptide and fibroblast growth factor-23 levels with abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus

Objective To explore the correlations of serum glucose-dependent insulin releasing peptide (GIP) and fibroblast growth factor-23 (FGF23) levels with abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus (GDM).

Methods A total of 82 patients with GDM were selected as research objects, and they were conducted with venous blood collection for detection of serum GIP and FGF23 levels. At 12 weeks after delivery, the 75 g oral glucose tolerance test (OGTT) was used to evaluate glucose metabolism status, and the GDM patients were divided into normal glucose metabolism group (n=66) and abnormal glucose metabolism group (n=16) according to the result of OGTT. Multivariate Logistic regression model was used to analyze the factors affecting abnormal postpartum glucose metabolism in GDM patients; the receiver operating characteristic (ROC) curve was used to analyze the values of serum GIP and FGF23 in predicting abnormal postpartum glucose metabolism in GDM patients.

Results The serum GIP level in the abnormal glucose metabolism group was significantly lower than that in the normal glucose metabolism group, while the FGF23 level was significantly higher than that in the normal glucose metabolism group (P < 0.05). High pre-pregnancy body mass index (BMI) and high FGF23 were the risk factors for abnormal postpartum glucose metabolism in GDM patients, while high GIP was a protective factor (P < 0.05). The values of area under the curve (AUC) of GIP, FGF23 and pre-pregnancy BMI in predicting abnormal postpartum glucose metabolism in GDM patients were 0.717, 0.625 and 0.699 respectively, and the AUC of GIP combined with FGF23 and pre-pregnancy BMI in predicting abnormal postpartum glucose metabolism in GDM patients was 0.890, which was significantly higher than that of GIP, pre-pregnancy BMI or FGF23 alone (P < 0.05).

Conclusion In GDM patients with abnormal postpartum glucose metabolism, serum GIP level reduces while FGF23 level increases, and these two indexes are related to abnormal postpartum glucose metabolism. Serum GIP and FGF23 can predict the risk of abnormal postpartum glucose metabolism in GDM patients.