Li Guanghui, Kong Lijun, Zhang Li, Fan Ling, Su Yixin, Rose James C, Zhang Weiyuan
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, NC, USA.
Reprod Sci. 2015 Jun;22(6):712-7. doi: 10.1177/1933719114557896. Epub 2014 Nov 12.
To determine associations between lipid profiles in early pregnancy stratified by body mass index (BMI) and risk of developing gestational diabetes mellitus (GDM).
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).
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.
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.
确定妊娠早期按体重指数（BMI）分层的血脂谱与发生妊娠期糖尿病（GDM）风险之间的关联。
前瞻性纳入了总共2488名健康孕妇。在妊娠11周左右测量空腹血浆血脂谱，包括甘油三酯（TGs）、总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和胆固醇（CHO）。我们评估了不同三分位数的妊娠早期母体血脂浓度与按BMI分层的GDM风险之间的关联。使用多变量逻辑回归分析通过计算比值比和95%置信区间（CIs）来估计GDM的相对风险。
在单变量分析中，与对照组相比，患有GDM的孕妇血清TG、CHO、LDL浓度、LDL/HDL比值显著升高，HDL浓度降低，各P均<0.01。在对混杂因素进行调整后，如果TG≥1.58 mmol/L，瘦组发生GDM的风险增加1.8倍（95% CI：1.2 - 2.7），肥胖组增加2.7倍（95% CI：1.1 - 6.6）。HDL≥2.22 mmol/L的瘦女性发生GDM的风险降低约50%（95% CI：0.3 - 0.9）。未观察到其他血脂谱与发生GDM风险之间存在显著相关性。
妊娠早期血脂异常与发生GDM的风险相关。TG浓度较高的瘦或肥胖女性发生GDM的风险增加，而HDL高的瘦女性受到保护。
