Abstract
BACKGROUND: Secreted Frizzled Related Protein 4 (sFRP4) is an inflammatory mediator and an antagonist of Wnt signalling, which has been implicated in the pathogenesis of T2DM by causing reduced insulin exocytosis. However, its association with gestational diabetes mellitus (GDM), has not been elucidated extensively. We measured and compared sFRP4 in pregnant women with and without GDM and evaluated the association between sFRP4 and insulin sensitivity indices. METHODS: We conducted a cross-sectional case-control study of 42 women with IADPSG-defined GDM and 36 normoglycaemic controls at 24-28 weeks' gestation. Plasma sFRP4 was quantified by ELISA, insulin on an automated analyser, and HOMA-IR/HOMA-β were calculated. Group differences were tested with t/Mann-Whitney U and χ² tests, and multivariable logistic and linear regressions (adjusted for age and BMI) assessed the association of sFRP4 with GDM risk and HOMA-IR (SPSS IBM 20, Stata 17; two-tailed P < 0.05). RESULTS: Median (IQR) sFRP4 concentrations were higher in women with GDM than in controls (287.2 (225-416) vs 230.8 (165-299) ng/mL; P = 0.018). Plasma sFRP4 was not significantly correlated with HOMA-IR or HOMA-β (r = 0.145 and 0.068, respectively). On multivariable logistic regression, each 1 kg/m² increase in BMI raised the odds of GDM by 27 % (OR = 1.27, 95 % CI 1.07-1.50; P = 0.006), and each 1 ng/mL increase in sFRP4 raised the odds by 0.4 % (OR = 1.004, 95 % CI 1.000-1.010; P = 0.033). CONCLUSION: Women with GDM have significantly higher sFRP4 levels as compared to healthy pregnant controls.