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甘油三酯与高密度脂蛋白胆固醇比值及妊娠期糖尿病和大于胎龄儿出生风险

Triglyceride to HDL cholesterol ratio and risk for gestational diabetes and birth of a large-for-gestational-age newborn.

作者信息

Barat Shahnaz, Ghanbarpour Azita, Bouzari Zinatossadat, Batebi Zohre

机构信息

Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

出版信息

Caspian J Intern Med. 2018 Fall;9(4):368-375. doi: 10.22088/cjim.9.4.368.

Abstract

BACKGROUND

Using oral glucose for glucose challenge test (GCT) and glucose tolerance test (GTT) is problematic, especially in early pregnancy when the pregnant woman is experiencing gastrointestinal complications. This research seeks to investigate the relationship between the ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) and the risk of gestational diabetes and large for gestational age (LGA) fetus for suggesting a more appropriate index for diagnosis of gestational diabetes.

METHODS

The present cross-sectional study investigated pregnant women visiting the Perinatal Clinic of Ayatollah Rouhani Hospital in Babol for prenatal care from September 2015-2016. The GCT was performed on these pregnant women at 24-28 weeks as a screening test and their lipid profile, including HDL-C and TG, was simultaneously assessed after eight to 14 hours of fasting.

RESULTS

Significant differences were observed between women with and without gestational diabetes in terms of mean triglyceride, HDL, LDL/HDL ratio, triglyceride/LDL ratio and triglyceride/HDL ratio. The cut-off point of TG/HDL in the GTT was 4.254 with a sensitivity of 79.07% and specificity of 78%.

CONCLUSIONS

According to the results obtained, lipid profile can help predict the risk of gestational diabetes, especially TG/HDL ratio that has a high sensitivity to diagnose gestational diabetes, while, lipid indices could not predict birth of a LGA neonate.

摘要

背景

使用口服葡萄糖进行葡萄糖耐量试验(GCT)和葡萄糖耐量测试(GTT)存在问题,尤其是在妊娠早期孕妇出现胃肠道并发症时。本研究旨在探讨甘油三酯(TG)与高密度脂蛋白胆固醇(HDL-C)的比值与妊娠期糖尿病风险和大于胎龄(LGA)胎儿的关系,以提出更合适的妊娠期糖尿病诊断指标。

方法

本横断面研究调查了2015年9月至2016年期间前往巴博勒阿亚图拉·鲁哈尼医院围产期诊所进行产前检查的孕妇。在这些孕妇24至28周时进行GCT作为筛查试验,并在禁食8至14小时后同时评估她们的血脂谱,包括HDL-C和TG。

结果

在平均甘油三酯、HDL、LDL/HDL比值、甘油三酯/LDL比值和甘油三酯/HDL比值方面,患有和未患有妊娠期糖尿病的女性之间存在显著差异。GTT中TG/HDL的切点为4.254,敏感性为79.07%,特异性为78%。

结论

根据所得结果,血脂谱有助于预测妊娠期糖尿病风险,尤其是TG/HDL比值对诊断妊娠期糖尿病具有较高敏感性,而血脂指标无法预测LGA新生儿的出生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33ca/6230466/18bb434d5741/cjim-9-368-g001.jpg

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