RBP4

This study aimed to explore the relationship between retinol-binding protein 4 (RBP4) concentrations measured at the first prenatal visit and the risk of gestational diabetes mellitus (GDM). The study involved 827 pregnant women, with data collected on fasting plasma glucose (FPG) and RBP4 levels during the first prenatal visit (at approximately 6 weeks of gestation). A subsequent GDM screening was conducted between 24-28 weeks. The results showed that higher RBP4 concentrations were significantly associated with an increased risk of developing GDM. Specifically, women in the second, third, and fourth quartiles of RBP4 had an increased risk of GDM by 54%, 205%, and 536%, respectively, compared to those in the first quartile. The addition of RBP4 levels to established GDM risk factors improved the prediction, as indicated by a significant increase in the area under the receiver operating characteristic curve (AUC). In women with obesity and elevated fatty acid-binding protein 4 (FABP4), the odds ratio (OR) for GDM risk was significantly higher (9.83) compared to women without obesity and with lower FABP4 levels. The findings suggest that elevated RBP4 in early pregnancy is a positive indicator of increased GDM risk, particularly in women with obesity and older age, potentially serving as an early predictive biomarker for GDM.