Han Emily S, Krauss Ronald M, Xu Fei, Sridhar Sneha B, Ferrara Assiamira, Quesenberry Charles P, Hedderson Monique M
Division of Research (E.S.H., F.X., S.B.S., A.F., C.P.Q., M.M.H.), Kaiser Permanente Northern California, Oakland, California 94612; and Children's Hospital Oakland Research Institute (R.M.K.), Oakland, California 94609.
J Clin Endocrinol Metab. 2016 Jul;101(7):2721-7. doi: 10.1210/jc.2015-3904. Epub 2016 Apr 5.
Lower low-density lipoprotein (LDL) peak diameter and a predominance of small, dense LDL are associated with type 2 diabetes, but it is unclear whether they are a risk factor for gestational diabetes mellitus (GDM).
To evaluate whether prepregnancy lipid profile predicts the development of GDM during pregnancy.
A nested case-control study among women who participated in a multiphasic health exam, where blood was collected and stored between 1984 and 1996, and who then had a subsequent pregnancy between 1984 and 2009.
Kaiser Permanente Northern California.
Cases were 254 women who developed GDM. Two controls were selected for each case and matched for year of blood draw, age at baseline, age at pregnancy, and number of intervening pregnancies.
Prepregnancy LDL peak diameter and prepregnancy lipid subfraction concentrations grouped according to size, and the odds of developing GDM.
Women in the lowest quartiles of LDL peak diameter and high-density lipoprotein had increased odds of GDM compared with women in the highest quartiles (odds ratio [95% CI], 2.60 [1.37-4.94] and 1.98 [1.01-3.86], respectively), in multivariable adjusted models. Being in the highest quartile of small and very small LDL subfractions also increased the odds of GDM (2.61 [1.35-5.03] and 2.44 [1.22-4.85], respectively).
Lower LDL peak diameter size and high-density lipoprotein levels and higher levels of small and very small LDL subfraction groups were present years before pregnancy in women who developed GDM. A prepregnancy atherogenic lipid profile may help identify women at risk of GDM to target for prevention.
较低的低密度脂蛋白（LDL）峰值直径以及以小而密的LDL为主与2型糖尿病相关，但它们是否为妊娠期糖尿病（GDM）的危险因素尚不清楚。
评估孕前血脂谱是否能预测孕期GDM的发生。
一项嵌套病例对照研究，研究对象为参加多阶段健康检查的女性，她们在1984年至1996年间采集并储存了血液，随后在1984年至2009年间再次怀孕。
北加利福尼亚州凯撒医疗集团。
病例组为254例患GDM的女性。为每个病例选择两名对照，对照与病例按采血年份、基线年龄、怀孕时年龄以及中间怀孕次数进行匹配。
孕前LDL峰值直径、按大小分组的孕前血脂亚组分浓度以及发生GDM的几率。
在多变量调整模型中，LDL峰值直径和高密度脂蛋白处于最低四分位数的女性发生GDM的几率高于处于最高四分位数的女性（优势比[95%可信区间]分别为2.60[1.37 - 4.94]和1.98[1.01 - 3.86]）。处于小LDL和非常小LDL亚组分最高四分位数的女性发生GDM的几率也增加（分别为2.61[1.35 - 5.03]和2.44[1.22 - 4.85]）。
患GDM的女性在怀孕前数年就存在较低的LDL峰值直径大小、高密度脂蛋白水平以及较高水平的小LDL和非常小LDL亚组分。孕前致动脉粥样硬化的血脂谱可能有助于识别有GDM风险的女性，以便进行预防。
