Circulating levels of fibroblast growth factor 21 in gestational diabetes mellitus: a meta-analysis

Endocr J. 2021 Mar 28;68(3):345-352. doi: 10.1507/endocrj.EJ20-0481. Epub 2020 Nov 6.


In recent times, the role of fibroblast growth factor 21 (FGF21) in patients with gestational diabetes mellitus (GDM) has been increasingly investigated. However, to our knowledge, no systematic analysis has been conducted yet to evaluate the relationship between FGF21 levels and GDM. Confirmed studies related to circulating FGF21 levels and GDM were searched from the databases of PubMed, ISI Web of Science, MEDLINE and EMBASE. Data were reported as standard mean difference (SMD) and associated 95% confidence intervals (CIs). Analysis were performed with Review Manager 5.2 and Stata version 11.0. A total of 392 cases and 435 controls in nine articles were included in this meta-analysis. The circulating FGF21 levels in pregnant women with GDM was higher than that in controls (random effects MD [95% CI] = 0.46, [0.07-0.86], p = 0.02). The result of multivariate meta-regression showed that sample size and point of sample collection contributed to heterogeneity (p = 0.033 and p = 0.047, respectively). Additionally, the results showed that there was no publication bias in this meta-analysis (Z = 1.36, p = 0.175; t = 1.24, p = 0.256, respectively). To conclude, this meta-analysis provides evidence that circulating FGF21 levels are higher in GDM subjects than controls, and it is important to clarify the relationship between circulating FGF21 levels and pregnant women with GDM in accurate prediction of GDM.

Keywords: Body mass index; Cytokines; Fibroblast growth factor 21 (FGF21); Gestational diabetes mellitus (GDM).

Publication types

  • Meta-Analysis

MeSH terms

  • Diabetes, Gestational / blood*
  • Female
  • Fibroblast Growth Factors / blood*
  • Humans
  • Pregnancy


  • FGF21 protein, human
  • Fibroblast Growth Factors