Serum follistatin-like-1 levels in gestational diabetes and the role of gene polymorphism in the development of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is known as glucose intolerance that occurs for the first time during pregnancy, and explaining the pathogenesis of GDM is very important in terms of preventing pregnancy complications.It has been shown that Follistatin Like-1 (FSTL-1), a new myokine, may play a role in inflammation and insulin resistance. and it has been the subject of many studies related to pathological processes in metabolic diseases.The aim of this study is to investigate the effect of serum FSTL-1 level and FSTL-1 gene rs869247 and rs12173 polymorphism on the development of GDM. 72 GDM patients diagnosed according to the OGTT results performed at 24-28 weeks (mean age: 29.54 ± 4.56 years)and 79 healthy pregnant individuals (mean age: 28,27 ± 4,47 years) without diabetes history were included in the study. Genotype analysis was performed on peripheral blood DNA by PCR method. The prevalencesof FSTL-1 polymorphism of the patients and controls were compared. Demographic characteristics and metabolic parameters (FSTL-1, fasting plasma glucose, fasting insulin, HbA1c, HOMA-IR, lipid profiles) of all participants were evaluated. The relationship between metabolic parameters and FSTL-1 polymorphism was examined. The mean BMI in the GDM group was higher than the control group (27.44 ± 5.46 kg/m2 vs. 25.39 ± 2.96 kg/m2, p<0.001). Fasting plasma glucose levels were higher in the GDM group than in the control group (87.43 ± 14.38 mg/dl vs. 75.29 ± 6.23 mg/dl, p<0.001). The mean HbA1c in the GDM group was found to be higher than in the control group (%5.11 ± 0.42 vs. 4.92% ± 0.30, p=0.002). The mean HOMA-IR was found to be higher in the GDM group than in the control group (2.61 ± 1.66 vs. 1.85 ± 1.11, p=0.006). Mean serum FSTL-1 levels in the GDM group were 339.35 ± 293.59 ng/mL, and mean serum FSTL-1 levels in the control group were414.53 ± 364.09 ng/mL.Although mean FSTL-1 were found to be lower in the GDM group than inthe controlgroup, this difference was not found to be statistically significant (p=0.917).There was no difference in the allele frequencies of FSTL-1 gene rs12173 polymorphism (respectively p=0.197, p=0.086) and FSTL-1 gene rs869247 polymorphism (respectively p=0.264, p=0.627).between GDM and control group. There was no significant relationship among FSTL-1 and genotypes of FSLT-1 rs12173 and rs869247 polymorhisms in patients with GDM (respectively p=0.339, p=0.514). No significant correlation was found among serum FSTL-1 levels and BMI and metabolic parameters (p>0.05). In conclusion, it was determined that the FSTL-1 gene rs12173 and rs869247 polymorphism had no effect on the development of GDM. Large scale studies are needed to find out the molecular mechanisms of FSTL-1 on metabolic diseases.