Early Pregnancy Maternal Lipid Profiles and the Risk of Gestational Diabetes Mellitus Stratified for Body Mass Index

Abstract

Objective: To determine associations between lipid profiles in early pregnancy stratified by body mass index (BMI) and risk of developing gestational diabetes mellitus (GDM). Study Design: A total of 2488 healthy pregnant women were enrolled prospectively. Fasting plasma lipid profiles were measured at mean 11 weeks of gestation including triglycerides (TGs), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and cholesterol (CHO). We assessed early pregnancy maternal lipid concentrations in different tertiles in association with the risk of GDM stratified for BMI. Multivariable logistic regression analyses were used to estimate the relative risk of GDM by calculating odds ratios and 95% confidence intervals (CIs). Results: In univariate analyses, pregnant women with GDM had significantly increased serum TG, CHO, LDL concentrations, LDL/HDL ratio, and decreased LDL concentrations, compared to control groups, each P < .01, respectively. After adjustment for confounders, there was a 1.8-fold increase in risk for GDM in the lean group (95% CI: 1.2-2.7) and 2.7-fold increase in the obese group (95% CI: 1.1-6.6), respectively, if TG 1.58 mmol/L. About a 50% decrease in the risk of GDM was observed in lean women with HDL 2.22 mmol/L (95% CI: 0.3-0.9). No significant correlations of other lipid profiles with the risk of developing GDM were observed. Conclusion: Early pregnancy dyslipidemia is associated with the risk of developing GDM. Lean or obese women with higher TG concentrations are at an increased risk for developing GDM while lean women with high HDL are protected.

Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI

“…Although hyperlipidemia is the physiological norm during human pregnancy, in complicated pregnancies the mechanisms regulating physiologic hyperlipidemia may malfunction, which has been associated with adverse pregnancy outcomes such as gestational diabetes mellitus (GDM) or pre‐eclampsia (PE) . Abnormal lipid profiles and species may have a role in the promotion of oxidative stress and vascular dysfunction observed in pre‐eclampsia .…”

“…GDM shares a similar pathophysiology with type 2 diabetes. Patients with insulin resistance and type 2 diabetes tend to have lipid and lipoprotein abnormalities, including elevated TG, lower high‐density lipoprotein cholesterol (HDL‐C), and higher low‐density lipoprotein cholesterol (LDL‐C) …”

“…There have been some studies that have proposed that lipids change throughout pregnancy according to pre‐pregnancy status, and that maternal lipid levels during early pregnancy are related to GDM or pre‐eclampsia . Middle trimester pregnancy BMI and blood lipids have not been analyzed for their potential impact upon pregnancy outcomes.…”

“…mellitus (GDM) or pre-eclampsia (PE). 8,9 Abnormal lipid profiles and species may have a role in the promotion of oxidative stress and vascular dysfunction observed in pre-eclampsia. 10 GDM shares a similar pathophysiology with type 2 diabetes.…”

“…Patients with insulin resistance and type 2 diabetes tend to have lipid and lipoprotein abnormalities, including elevated TG, lower high-density lipoprotein cholesterol (HDL-C), and higher low-density lipoprotein cholesterol (LDL-C). 8 There have been some studies that have proposed that lipids change throughout pregnancy according to pre-pregnancy status, 11 and that maternal lipid levels during early pregnancy are related to GDM or pre-eclampsia. 8,9 Middle trimester pregnancy BMI and blood lipids have not been analyzed for their potential impact upon pregnancy outcomes.…”