Expression of FABP4 and CXCL12 in patients with gestational diabetes mellitus and their association with insulin resistance and pregnancy outcomes
Li Guorong , Huang Zhiying , Zhao Xiulan, et al
1.Department of Obstetrics, Handan Second Hospital, Handan, Hebei 056001, China; 2.Department of Gynecology, the Second Affiliated Hospital of Xingtai Medical University, Xingtai, Hebei 054000, China; 3.Department of Gynecology, Handan First Hospital, Handan, Hebei 056000, China; 4.Delivery Room, Handan Second Hospital, Handan, Hebei 056001, China
Objective To investigate the association between serum levels of fatty acid binding protein 4 (FABP4) and C-X-C motif chemokine ligand 12 (CXCL12) and insulin resistance (IR) in patients with gestational diabetes mellitus (GDM), as well as their predictive value for adverse pregnancy outcomes. Methods A retrospective analysis was conducted. A total of 73 pregnant women diagnosed with GDM by oral glucose tolerance test (OGTT) who delivered in Handan Second Hospital from April 2023 to October 2024 were selected as the GDM group, and 73 pregnant women with normal OGTT results during the same period were selected as the normal group. Fasting serum insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), and lipid indices, including high-density lipoprotein cholesterol (HDL), triglyceride (TG), total cholesterol (TC), were compared between the two groups. Pearson method was used to assess the associations between serum FABP4 and CXCL12 levels and fasting blood glucose, FINS, and HOMA-IR in patients with GDM. Patients in the GDM group were further categorized into the poor pregnancy outcome group (n=22) and the good pregnancy outcome group (n=51) according to whether they experienced an adverse pregnancy outcome. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the predictive value of serum FABP4 and CXCL12 for adverse pregnancy outcomes, and multivariate Logistic regression analysis was used to identify independent risk factors for adverse pregnancy outcomes in patients with GDM. Statistical analyses were performed using independent sample t-test and χ2 test. Results Compared with the normal group, the GDM group had higher levels of fasting blood glucose, 2-hour postprandial blood glucose, FINS, HOMA-IR, serum FABP4 and CXCL12 [(6.03±1.12) mmol/L vs (4.04±1.02) mmol/L, (10.63±1.49) mmol/L vs(6.84±1.55) mmol/L, (14.52±3.11) mU/L vs (9.36 ±3.08) mU/L, 3.21±0.43 vs 2.56±0.41, (16.13±2.87) μg/L vs (10.97±2.61) μg/L, (9.34±2.36) μg/L vs (4.12±1.03) μg/L, with t values of -11.224, -13.540, -9.055, -8.403, -10.217, and -15.571, respectively, all P<0.001]. Pearson correlation analysis revealed that serum FABP4 and CXCL12 levels were significantly positively correlated with fasting blood glucose (with r values of 0.550, 0.414, all P<0.001), FINS (with r values of 0.235, 0.185, all P<0.05), HOMA-IR (with r values of 0.448, 0.345, all P<0.001). Compared with the good pregnancy outcome
group, the poor pregnancy outcome group had significantly higher serum FINS, FABP4, and CXCL12 levels [(15.72±3.11) mU/L vs (12.46±3.12) mU/L, (17.15±2.17) μg/L vs (14.13±2.11) μg/L, and (9.58±2.01) μg/L vs (7.34±1.36) μg/L, with t values of 4.100, 5.564, and 5.557, respectively, all P<0.001]. ROC curve analysis showed that the AUC values for FABP4 and CXCL12 in predicting adverse pregnancy outcomes in GDM patients were 0.858 (95% CI: 0.756–0.929) and 0.842 (95% CI: 0.738-0.917), respectively. Multivariate Logistic regression analysis revealed that serum FABP4 and CXCL12 were both independent risk factors for adverse pregnancy outcomes in patients with GDM (all P<0.05). Conclusions Serum FABP4 and CXCL12 are closely correlated with insulin resistance in pregnant women with GDM, and both are independent risk factors for adverse pregnancy outcomes, and exhibit favorable predictive value for adverse pregnancy outcomes in GDM patients.
[J]. 发育医学电子杂志, 2026, 14(5): 412-419.
Li Guorong , Huang Zhiying , Zhao Xiulan, et al. Expression of FABP4 and CXCL12 in patients with gestational diabetes mellitus and their association with insulin resistance and pregnancy outcomes. Journal of Developmental Medicine(Electronic Version), 2026, 14(5): 412-419.
2026, Vol. 14 
