Circulating fibroblast growth factor 21 levels in gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis.

Background: The connection between fibroblast growth factor 21 (FGF21) and the likelihood of gestational diabetes mellitus (GDM) or preeclampsia (PE) has received more attention recently. Based on published articles, meta-analysis were conducted to explore the differences in FGF21 levels in GDM or PE compared to control groups.

Methods: Articles published before April 5, 2024 were searched across four databases: PubMed, Web of Science, Embase, and Cochrane Library, and studies exploring the association of FGF21 levels and GDM or PE were collected. Additionally, ClinicalTrials.gov was also searched for completed and ongoing trials. (Prospero Registration CRD42024504738). The standardized mean differences (SMDs) and 95% confidence intervals (CIs) were utilized to determine FGF21 levels among different groups.

Results: This analysis incorporated a total of 16 articles, with 714 GDM and 701 non-GDM in the control group. The GDM-affected pregnant women had greater levels of circulating FGF21 than the control group (SMD = 0.529, 95% CI: 0.168 ~ 0.890, p = 0.004). Moreover, the PE case group covered 120 while the control group contained 134. The findings indicated that pregnant women with PE had significantly greater levels of circulating FGF21 than healthy expectant mothers (SMD = 0.743, 95% CI: 0.527 ~ 0.958, p = 0.000).

Conclusions: Our study found that FGF21 has the potential to serve as a diagnostic marker for GDM or PE. However, due to the limited number of studies and the fact that most data were from the second and third trimesters of pregnancy, more large-scale prospective studies are needed to validate these conclusions, investigate the potential of FGF21 in enabling early diagnosis, and further examine the role of FGF21 in the development and progression of GDM/PE.

Trial Registration: Not applicable.