Rahnemaei Fatemeh Alsadat, Pakzad Reza, Amirian Azam, Pakzad Iraj, Abdi Fatemeh
Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
Open Med (Wars). 2021 Dec 15;17(1):70-86. doi: 10.1515/med-2021-0408. eCollection 2022.
Gestational diabetes mellitus (GDM) can have adverse effects on pregnancy. GDM is associated with changes in the lipid profile of pregnant women. Finding out the early ways to diagnose GDM can prevent the adverse outcomes. This meta-analysis study aimed to determine the effect of GDM on lipid profile. PubMed, ProQuest, Web of Science, Scopus, Science Direct, Google Scholar, and ClinicalTrial were systematically searched for published articles relating to GDM until 2021 according to PRISMA guidelines. Newcastle Ottawa scale was used to assess the quality of the studies. Thirty-three studies with a sample size of 23,792 met the criteria for entering the meta-analysis. Pooled standardized mean difference (SMD) for total cholesterol (TC) and triglyceride (TG) was 0.23 mg/dL (95% CI: 0.11-0.34) and 1.14 mg/dL (95% CI: 0.91-1.38), respectively. The mean of TC and TG in people with GDM was higher than that in normal pregnant women. A similar pattern was observed for the very low-density lipoprotein (VLDL) and TG/high-density lipoprotein (HDL) ratio, with pooled SMD of 0.99 mg (95% CI: 0.71-1.27) and 0.65 mg (95% CI: 0.36-0.94), respectively. Pooled SMD for HDL was -0.35 mg/dL (95% CI: -0.54 to -0.16), women with GDM had a mean HDL lower than normal pregnant women. Although pooled SMD was higher for low-density lipoprotein (LDL) in the GDM group, this difference was not significant (0.14 [95% CI: -0.04 to 0.32]). Of all the lipid profiles, the largest difference between the GDM and control groups was observed in TG (SMD: 1.14). Elevated serum TG had the strongest effect on GDM. Higher levels of TC, LDL, VLDL, and TG/HDL ratio, and lower level of HDL were exhibited in GDM group. So, these markers can be considered as a reliable marker in the diagnosis of GDM.
妊娠期糖尿病（GDM）可对妊娠产生不良影响。GDM与孕妇血脂谱的变化有关。找出早期诊断GDM的方法可以预防不良后果。这项荟萃分析研究旨在确定GDM对血脂谱的影响。根据PRISMA指南，对PubMed、ProQuest、科学网、Scopus、Science Direct、谷歌学术和ClinicalTrial进行了系统检索，以查找截至2021年与GDM相关的已发表文章。采用纽卡斯尔渥太华量表评估研究质量。33项样本量为23792的研究符合纳入荟萃分析的标准。总胆固醇（TC）和甘油三酯（TG）的合并标准化均值差（SMD）分别为0.23mg/dL（95%CI：0.11 - 0.34）和1.14mg/dL（95%CI：0.91 - 1.38）。GDM患者的TC和TG均值高于正常孕妇。极低密度脂蛋白（VLDL）和TG/高密度脂蛋白（HDL）比值也观察到类似模式，合并SMD分别为0.99mg（95%CI：0.71 - 1,27）和0.65mg（95%CI：0.36 - 0.94）。HDL的合并SMD为 - 0.35mg/dL（95%CI： - 0.54至 - 0.16），GDM女性的HDL均值低于正常孕妇。虽然GDM组低密度脂蛋白（LDL）的合并SMD较高，但差异不显著（0.14[95%CI： - 0.04至0.32]）。在所有血脂谱中，GDM组与对照组之间在TG方面差异最大（SMD：1.14）。血清TG升高对GDM的影响最强。GDM组表现出较高水平的TC、LDL、VLDL和TG/HDL比值，以及较低水平的HDL。因此，这些标志物可被视为诊断GDM的可靠标志物。
