title: Changes in lipid profile after treatment of women with gestational diabetes mellitus.
abstract: BACKGROUND
  Insulin resistance, a key factor in the pathophysiology of gestational diabetes mellitus (GDM), is associated with an atherogenic lipid profile. Lipid metabolism is altered during normal pregnancy, but it is still unknown how the treatment of GDM affects lipoprotein concentrations.
  
  
  OBJECTIVE
  To evaluate maternal lipids at GDM diagnosis, after treatment, and in the puerperium and analyze the influence of BMI, insulin requirement, and glycemic control on lipoproteins.
  
  
  METHODS
  In this observational prospective study, total cholesterol (TC), HDL, and triglycerides (TG) were measured, and LDL was calculated at diagnosis (Dx), at 3-6 weeks after GDM treatment initiation (PI, post initiation) and 6-week postpartum (PP). Subgroups analyses were performed according to categories of maternal BMI, insulin requirement, and quality of glucose control.
  
  
  RESULTS
  TC and TG increased from Dx to PI and decreased in PP (TC: 213.6 mg/dL, 223.9 mg/dL, and 195.5 mg/dL; TG: 181.5 mg/dL, 203.5 mg/dL, and 100.5 mg/dL, at Dx, PI, and PP, respectively; P < .0001). HDL declined in the puerperium (Dx = 60 mg/dL, PI = 60.8 mg/dL, PP = 51.8 mg/dL; P < .0001 for Dx-PP and PI-PP, respectively). Insulin-treated patients showed an increase in LDL from Dx to PP, whereas LDL declined in the diet-only group (12 vs -11.1 mg/dL, P = .010). TC and TG increased from Dx to PI in patients with adequate glycemic control and decreased in the uncontrolled subgroup (TC: 15.5 vs -1.2 mg/dL, P = .041; TG: 29.7 vs -12.5 mg/dL, P = .07). No significant differences in lipids variation were observed according to BMI.
  
  
  CONCLUSIONS
  Insulin requirement and glycemic control status directly affected the variation of lipid profile in women with GDM.
authors.affiliation: Internal Medicine Department, Diabetes Section-Federal University of Rio de Janeiro, Brazil. Electronic address: vnkern@gmail.com.
authors.forename: Vivian Nunes
authors.initials: VN
authors.lastname: Kern Pessôa
authors.affiliation: Internal Medicine Department, Diabetes Section-Federal University of Rio de Janeiro, Brazil.
authors.forename: Melanie
authors.initials: M
authors.lastname: Rodacki
authors.affiliation: Bauru's Diabetics Association, Bauru, São Paulo, Brazil.
authors.forename: Carlos Antonio
authors.initials: CA
authors.lastname: Negrato
authors.affiliation: Internal Medicine Department, Diabetes Section-Federal University of Rio de Janeiro, Brazil.
authors.forename: Lenita
authors.initials: L
authors.lastname: Zajdenverg
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids
keywords: Body mass index; Gestational diabetes; Insulin treatment; Lipids; Pregnancy