Hu Jiamiao, Gillies Clare L, Lin Shaoling, Stewart Zoe A, Melford Sarah E, Abrams Keith R, Baker Philip N, Khunti Kamlesh, Tan Bee K
College of Food Science, Fujian Agriculture and Forestry University, Fuzhou 350002, PR China.
Department of Cardiovascular Sciences and Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, United Kingdom.
EClinicalMedicine. 2021 Apr 16;34:100830. doi: 10.1016/j.eclinm.2021.100830. eCollection 2021 Apr.
Gestational Diabetes Mellitus (GDM) is the most prevalent metabolic disorder during pregnancy, however, the association between dyslipidaemia and GDM remains unclear.
We searched Medline, Scopus, Web of Science, Cochrane, Maternity and Infant Care database (MIDIRS) and ClinicalTrials.gov up to February 2021 for relevant studies which reported on the circulating lipid profile during pregnancy, in women with and without GDM. Publications describing original data with at least one raw lipid [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or very low-density lipoprotein cholesterol (VLDL-C)] measurement were retained. Data extraction was performed using a piloted data extraction form. The protocol was registered with PROSPERO (CRD42019139696).
A total of 292 studies, comprising of 97,880 pregnant women (28232 GDM and 69,648 controls) were included. Using random-effects meta-analysis models to pool study estimates, women with GDM had significantly higher (by 20%) TG levels, with a pooled weighted mean difference between GDM and non-GDM pregnancies of 0.388 mM (0.336, 0.439, < 0.001). Further analyses revealed elevated TG levels occur in the first trimester and persist afterwards. Meta-regression analyses showed that differences in TG levels between women with GDM and healthy controls were significantly associated with age, BMI, study continent, OGTT procedure, and GDM diagnosis criteria.
Elevated lipids, particularly, TG, are associated with GDM.
妊娠期糖尿病（GDM）是孕期最常见的代谢紊乱疾病，然而，血脂异常与GDM之间的关联仍不明确。
截至2021年2月，我们检索了Medline、Scopus、科学网、Cochrane、母婴护理数据库（MIDIRS）和ClinicalTrials.gov，以查找有关妊娠期间有或无GDM的女性循环血脂谱的相关研究。保留了描述至少一项原始血脂[甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）或极低密度脂蛋白胆固醇（VLDL-C）]测量的原始数据的出版物。使用预先设计的数据提取表进行数据提取。该方案已在PROSPERO（CRD42019139696）注册。
共纳入292项研究，包括97880名孕妇（28232例GDM患者和69648例对照）。使用随机效应荟萃分析模型汇总研究估计值，GDM女性的TG水平显著更高（高20%），GDM与非GDM妊娠之间的合并加权平均差异为0.388 mM（0.336，0.439，< 0.001）。进一步分析显示，TG水平在孕早期升高并持续至之后。荟萃回归分析表明，GDM女性与健康对照之间TG水平的差异与年龄、BMI、研究所在大洲、口服葡萄糖耐量试验程序和GDM诊断标准显著相关。
血脂升高，尤其是TG，与GDM有关。
