Correlation analysis of serum Orexin A, PBP4, and FGF19 levels with insulin resistance and neonatal weight in gestational diabetes mellitus: A cross-sectional study

The purpose of this study was to investigate the relationships between serum biomarkers Orexin A, PBP4, FGF19, and insulin resistance as measured by HOMA-IR, and neonatal weight in patients with gestational diabetes mellitus (GDM). A total of 80 pregnant women diagnosed with GDM were enrolled in this cross-sectional study. Baseline characteristics, including age, body mass index (BMI), and gestational age, were recorded. Fasting blood samples were collected to assess serum levels of Orexin A, PBP4, and FGF19, as well as to calculate HOMA-IR as a measure of insulin resistance. Neonatal birth weight was documented at delivery. Statistical analyses included Pearson correlation, multivariate linear regression, and subgroup analysis based on median values of HOMA-IR and neonatal birth weight. A statistically significant positive correlation was observed between insulin resistance, and neonatal birth weight (R = 0.45, P < .001). The low HOMA-IR group has significantly higher levels of Orexin A, PBP4, and FGF19 compared to the high HOMA-IR group (P-values: .02, .04, and .01, respectively), indicating a negative association with insulin resistance. Orexin A, PBP4 and FGF19 are negatively associated with both insulin resistance (P < .01, P < .01, P = .03) and birth weight (P = .02, P < .01, P = .02). Furthermore, a moderation effect of BMI on the relationship between PBP4 levels and insulin resistance, with stronger associations observed in women with a higher BMI. The study reveals that serum Orexin A, PBP4, and FGF19 are significantly associated with insulin resistance and neonatal weight in GDM, with BMI modulating the impact of PBP4 on insulin resistance. These biomarkers could serve as predictive indicators for insulin resistance and fetal growth in GDM, suggesting potential mechanism of insulin resistance affecting newborn weight.