FABP4 and I-FABP Levels in Pregnant Women Are Associated with Body Mass Index but Not Gestational Diabetes

Abstract

Objectives. Gestational diabetes mellitus (GDM) is glucose intolerance detected initially during pregnancy. GDM poses an increased risk for the development of diabetes later in life. Fatty acid-binding protein 4 (FABP4) is a regulator of lipid metabolism and is associated with obesity, insulin resistance, and type 2 diabetes. Increased level of intestinal fatty acid-binding protein (I-FABP) may indicate impaired intestinal permeability, which may be an important contributor to the pathogenesis of type 1 diabetes and GDM. We aimed to compare FABP4 and I-FABP levels in pregnant women with GDM and in healthy pregnant controls, taking into consideration their prepregnancy body mass index (BMI), past exposures to enteroviruses (EV), and adipokine and cytokine levels, which have been shown to decrease insulin sensitivity. Material and Methods. Forty patients with GDM (median age 30.5) and 40 pregnant healthy controls (median age 31.1) were divided on the basis of their prepregnancy BMI into two groups: normal weight ( BMI < 25 , n = 20 ) and overweight ( BMI ≥ 25 , n = 20 ). FABP4 and I-FABP were measured from serum samples using commercial ELISA kits. Results. FABP4 and I-FABP levels did not differ between women with GDM and healthy pregnant controls ( p > 0.05 for both comparisons). However, both levels were associated with BMI ( p < 0.001 for both comparisons). Median I-FABP level was the highest in healthy controls with lower BMI (<25) ( p = 0.0009 ). FABP4 levels correlated with BMI and C-peptide values in both groups ( p < 0.001 ). Anti-EV antibody levels did not correlate with FABP4 or I-FABP levels. FABP4 and adiponectin levels were negatively correlated in controls ( r = − 0.61 , p = 0.0009 ), while I-FABP correlated positively with adiponectin ( r = 0.58 , p = 0.04 ) and resistin ( r = 0.67 , p = 0.04 ) levels in the GDM group. Conclusion. FABP4 and I-FABP levels were not dependent on the diagnosis of GDM, but rather on BMI. The correlation of I-FABP with adiponectin and resistin levels in women with GDM may suggests the importance of lipid metabolism in GDM-associated changes in intestinal permeability.

Pathophysiological Insight into Fatty Acid-Binding Protein-4: Multifaced Roles in Reproduction, Pregnancy, and Offspring Health

“…Consistently, lines of evidence also revealed that serum FABP4 levels are positively associated with maternal BMI [ 28 ], especially in the subgroup with BMI surpassing 25 [ 29 ]. Moreover, maternal circulating FABP4 levels are also negatively associated with serum adiponectin levels, which is a metabolically beneficial hormone [ 29 ]. These findings underscore that elevated FABP4 levels are intricately linked to adiposity gain during pregnancy, thus suggesting that FABP4 levels could serve as a predictive indicator of the degree of maternal obesity.…”

“…Growing studies demonstrate that elevated circulating FABP4 levels correlate with an increased risk for obesity [ 24 ], type 2 diabetes [ 25 ], various cardiovascular diseases [ 26 ], and cancers [ 27 ] in a wide variety of populations. In pregnancy, increased serum FABP4 concentrations are observed in pregnant women with maternal obesity [ 28 , 29 ], GDM [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], and PE [ 28 , 40 , 41 , 42 ]. However, its expression is detected in human placental trophoblast cells and is dispensable for maternal–fetal exchange and fetal growth [ 43 ].…”

A New Insight into Fatty Acid Binding Protein 4 Mechanisms and Therapeutic Implications in Obesity‐Associated Diseases: A Mini Review

“…It was observed that FABP4 increased in circulation as BMI increased in women participating in the study and interestingly both A‐FABP and I‐FABP were related higher BMI. [ 28,42 ]…”

Adipose tissue‐derived FABP4 mediates glucagon‐stimulated hepatic glucose production in gestational diabetes

“…Previous studies by us and others showed increased circulating levels of FABP4 in women with GDM compared women with normal glucose tolerance (NGT) 26–30 . Yet, a causal link between increased FABP4 and the pathophysiology of GDM has not been shown, and it is unclear whether the increase in FABP4 is related to obesity or to the related metabolic abnormalities 31 …”

“…[26][27][28][29][30] Yet, a causal link between increased FABP4 and the pathophysiology of GDM has not been shown, and it is unclear whether the increase in FABP4 is related to obesity or to the related metabolic abnormalities. 31 In this study, we aimed to determine the tissue origin of elevated circulating FABP4 levels in GDM and to assess its potential contribution in promoting hepatic glucose production. Using biopsies of placenta, subcutaneous and visceral white adipose tissues (sWAT and vWAT, respectively), we showed that FABP4 is secreted from these tissues during pregnancy, with an approximately two-fold increase in vWAT secretion observed in women with GDM compared with NGT.…”