In multivariable logistic regression analysis, compared with the lowest RBP4 level, subjects in the highest quartile of RBP4 was associated with a significantly higher risk of GDM in both first trimester (aOR = 3.63; 95% CI, 1.30~10.12; P-trend = 0.004) and second trimester (aOR = 3.26; 95% CI, 1.09~9.72; P-trend = 0.018) after adjusting for maternal age, education, occupation, gestational weeks of RBP4 measurements in the first trimester, pre-pregnancy BMI, GWG before OGTT, SBP, and DBP. This evidence concerns the gene RBP4 and gestational diabetes.