Association between circulating visfatin and gestational diabetes mellitus: a systematic review and meta-analysis.

AIMS: Gestational diabetes mellitus (GDM) is a medical complication of any degree of glucose intolerance with onset or first recognition during pregnancy. Although visfatin is commonly considered to be related to GDM, studies revealed inconsistent results. This study aimed to clarify the relationship between visfatin and GDM.

METHODS: The protocol for this study was registered in PROSPERO (No. CRD42018086204) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and Embase databases were used to search for relevant studies published up to September 30, 2017. The difference of visfatin levels between women with GDM and the controls was measured by standardised mean difference (SMD) and 95% confidence interval (CI).

RESULTS: Twenty-six studies that were published in 24 articles met the inclusion criteria, in which 2305 participants (1033 with GDM, mean age 31.39 years and 1272 controls, and mean age 29.99 years) were included. The quantitative meta-analysis revealed no significant difference in circulating visfatin levels between women with GDM and the controls (SMD = 0.249, 95% CI = - 0.079 to 0.576, P = 0.137). Subgroup analyses were performed referring to body mass index (BMI) where inconsistent results have been observed between cases and controls groups. For the ten studies, in which the level of BMI in women with GDM was higher than that in the control group, the pooled result showed that circulating visfatin was significantly higher among women with GDM than the controls (SMD = 0.367, 95% CI = 0.06 to 0.728, P = 0.046). Of other 16 studies BMI-matched, the pooled SMD illustrated no difference of visfatin.

CONCLUSIONS: Our study elucidates that visfatin is not independently associated with GDM. Visfatin is linked to GDM through maternal overweight/obesity, which is one of the major factors leading to the development of GDM.