Cord Blood Fetuin-B, Fetal Growth Factors, and Lipids in Gestational Diabetes Mellitus

Context Fetuin-B is a hepatokine/adipokine implicated in glucose homeostasis and lipid metabolism. Objective We sought to assess whether cord blood fetuin-B levels are altered in gestational diabetes mellitus (GDM) and the association with fetal growth factors and lipids. Methods In a nested, case-control study of 153 pairs of neonates of mothers with GDM and euglycemic pregnancies in the Shanghai Birth Cohort, we assessed cord blood fetuin-B in relation to fetal growth factors and lipids (high-density lipoprotein, low-density lipoprotein [LDL], total cholesterol [TC], and triglycerides). Results Cord blood fetuin-B concentrations were higher in the newborns of GDM vs euglycemic mothers (mean ± SD: 2.35 ± 0.96 vs 2.05 ± 0.73 mg/L; P = .012), and were positively correlated with LDL (r = 0.239; P < .0001), TC (r = 0.230; P = .0001), insulin-like growth factor-Ⅰ (IGF-Ⅰ) (r = 0.137; P = .023) and IGF-Ⅱ (r = 0.148; P = .014) concentrations. Similar associations were observed adjusting for maternal and neonatal characteristics. Conclusion The study is the first to demonstrate that fetuin-B levels are elevated in fetal life in GDM, and that fetuin-B affects lipid metabolic health during fetal life in humans. The secretion of fetuin-B appears to be related to the secretion of IGF-Ⅰ and IGF-Ⅱ.