Association between serum neuregulin 4 and the risk of gestational diabetes mellitus: A 1:1 matched case–control study

Neuregulin 4 (NRG4) , which belongs to the neuregulin growth factor family, is secreted from brown adipose tissue and now is extensively identified as a novel adipokine that improves insulin sensitivity.

The purpose of the study was to investigate the possible association between serum NRG4 levels and GDM risk in Chinese pregnant women.

A 1:1 matched case–control study was conducted in Chinese pregnant women between July 2018 and July 2019, involving 87 GDM cases and 87 controls. For all participants, anthropometric parameters and biochemical parameters were measured. Multivariate conditional logistic regression was used to analyze the relationship between serum NRG4 level and GDM risk.

The serum NRG4 level was negatively correlated with 1 h plasma glucose, 2 h plasma glucose, and HOMA-IR (r =  − 0.304, p < 0.001; r =  − 0.273, p < 0.001; r =  − 0.161, p = 0.034, respectively). The fully adjusted multivariate conditional logistic regression analysis showed that odds ratios (ORs) and 95% confidence intervals (CIs) of GDM for the subjects in Q2, Q3, and Q4 compared to the subjects in Q1 of serum NRG4 level were 0.072 (0.015–0.353), 0.129 (0.029–0.572), and 0.042 (0.009–0.206), respectively (all p < 0.05). An optimal cut-off value 0.58 ng/mL of serum NRG4 had 92% sensitivity and 42.5% specificity for predicting GDM. The area under the curve (AUC) value was 0.714 (95% CI: 0.684 ~ 0.790, p < 0.001).

Elevated serum NRG4 level is associated with a lower GDM risk in Chinese women. And NRG4 might be a potential biomarker for the diagnosis of GDM.