title: Determinants of maternal triglycerides in women with gestational diabetes mellitus in the Metformin in Gestational Diabetes (MiG) study.
abstract: OBJECTIVE
  Factors associated with increasing maternal triglyceride concentrations in late pregnancy include gestational age, obesity, preeclampsia, and altered glucose metabolism. In a subgroup of women in the Metformin in Gestational Diabetes (MiG) trial, maternal plasma triglycerides increased more between enrollment (30 weeks) and 36 weeks in those treated with metformin compared with insulin. The aim of this study was to explain this finding by examining factors potentially related to triglycerides in these women.
  
  
  METHODS
  Of the 733 women randomized to metformin or insulin in the MiG trial, 432 (219 metformin and 213 insulin) had fasting plasma triglycerides measured at enrollment and at 36 weeks. Factors associated with maternal triglycerides were assessed using general linear modeling.
  
  
  RESULTS
  Mean plasma triglyceride concentrations were 2.43 (95% CI 2.35-2.51) mmol/L at enrollment. Triglycerides were higher at 36 weeks in women randomized to metformin (2.94 [2.80-3.08] mmol/L; +23.13% [18.72-27.53%]) than insulin (2.65 [2.54-2.77] mmol/L, P = 0.002; +14.36% [10.91-17.82%], P = 0.002). At 36 weeks, triglycerides were associated with HbA1c (P = 0.03), ethnicity (P = 0.001), and treatment allocation (P = 0.005). In insulin-treated women, 36-week triglycerides were associated with 36-week HbA1c (P = 0.02), and in metformin-treated women, they were related to ethnicity.
  
  
  CONCLUSIONS
  At 36 weeks, maternal triglycerides were related to glucose control in women treated with insulin and ethnicity in women treated with metformin. Whether there are ethnicity-related dietary changes or differences in metformin response that alter the relationship between glucose control and triglycerides requires further study.
authors: UQ Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia. h.barrett@uq.edu.au
authors: Helen L
authors: HL
authors: Barrett
authors: Marloes
authors: M
authors: Dekker Nitert
authors: Lee
authors: L
authors: Jones
authors: Peter
authors: P
authors: O'Rourke
authors: Karin
authors: K
authors: Lust
authors: Kathryn L
authors: KL
authors: Gatford
authors: Miles J
authors: MJ
authors: De Blasio
authors: Suzette
authors: S
authors: Coat
authors: Julie A
authors: JA
authors: Owens
authors: William M
authors: WM
authors: Hague
authors: H David
authors: HD
authors: McIntyre
authors: Leonie
authors: L
authors: Callaway
authors: Janet
authors: J
authors: Rowan
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides; D008687:Metformin
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