title: Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.
abstract: Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Chaoqun
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Chunrong
authors.initials: C
authors.lastname: Zhong
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Xuezhen
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Renjuan
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Jiangyue
authors.initials: J
authors.lastname: Wu
authors.affiliation: Departments of Epidemiology and Health Statistic, Wuhan, China.
authors.forename: Weiye
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Xiating
authors.initials: X
authors.lastname: Li
authors.affiliation: Departments of Epidemiology and Health Statistic, Wuhan, China.
authors.forename: Huisi
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China.
authors.forename: Xingwen
authors.initials: X
authors.lastname: Hu
authors.affiliation: The Central Hospital of Wuhan, Wuhan, 430014, Hubei, China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Xiong
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Hao
authors.affiliation: Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Xiao
authors.affiliation: Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. zynh@mails.tjmu.edu.cn.
authors.forename: Nianhong
authors.initials: N
authors.lastname: Yang
mesh_terms: D000328:Adult; D044466:Asian People; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D019456:Health Transition; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D015994:Incidence; D062145:Maternal Serum Screening Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D001663:Bilirubin
keywords: Direct bilirubin; Fast blood-glucose; Gestational diabetes mellitus; Pregnant women; Total bilirubin