Elevated Serum Tsukushi Levels and Their Association with Glycolipid Metabolism in Gestational Diabetes Mellitus Patients

Xiangjie Wu,1 Jue Jia,1 Xia Deng,1 Xiaoyan Ma,2 Guoyue Yuan,1 Ling Yang,1 Haoxiang Li1 1Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China; 2Department of Obstetrics, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of ChinaCorrespondence: Haoxiang Li, Email [email protected] Ling Yang, Email [email protected]: Tsukushi (TSK) is a recently identified hepatic factor that has gained prominence for its distinctive function in glycolipid metabolism and energy homeostasis. However, the role of TSK in gestational diabetes mellitus (GDM) remains largely unexplored. In this study, we conducted a pioneering investigation by determining serum TSK levels in patients with GDM and examining the correlation between these levels and various metabolic parameters in gestational diabetes patients.Methods: A total of 176 pregnant women (mean age 29.5 ± 3.2 years) were recruited from September 2023 to December 2024. Serum TSK levels and clinical markers related to glycolipid metabolism were measured at 24– 28 weeks of gestation. All subjects underwent an oral glucose tolerance test (OGTT).Results: Serum TSK was significantly higher in patients with GDM than in the normal glucose tolerance group [0.60(0.47,0.73 vs 0.52(0.42,0.67) ng/mL; P < 0.05]. Correlation analysis showed that TSK was significantly and positively correlated with diastolic blood pressure (DBP), alanine aminotransferase (ALT), direct bilirubin (Dbil), free triiodothyronine (FT3), 1-h post-OGTT glucose (1hPG), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC). Logistic regression analysis showed that Logistic regression analysis showed that higher TSK levels were independently associated with increased odds of GDM.Conclusion: TSK levels were higher in GDM than in NGT (P=0.013), and higher TSK tertiles were independently associated with increased odds of GDM (Model 3 OR=2.883, 95% CI 1.173– 7.084; P=0.021). After FDR correction, only the association with total cholesterol remained significant (FDR-adjusted P=0.023).Keywords: Tsukushi, gestational diabetes mellitus, pregnancy, insulin resistance