Early Pregnancy Maternal Lipid Profiles and the Risk of Gestational Diabetes Mellitus Stratified for Body Mass Index.
OBJECTIVE
To determine associations between lipid profiles in early pregnancy stratified by body mass index (BMI) and risk of developing gestational diabetes mellitus (GDM).


METHODS
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.


CONCLUSIONS
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.
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Guanghui
G
Li
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Lijun
L
Kong
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Li
L
Zhang
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Ling
L
Fan
Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, NC, USA.
Yixin
Y
Su
Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, NC, USA.
James C
JC
Rose
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China zhangwy9921@163.com.
Weiyuan
W
Zhang
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D055815:Young Adult
D015415:Biomarkers; D008055:Lipids
body mass index; gestational diabetes mellitus; high-density lipoprotein cholesterol; pregnancy; triglycerides