Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
Nutrients. 2023 Aug 31;15(17):3809. doi: 10.3390/nu15173809.
This study aims to determine the association of pregnancy cholesterol metabolism markers with gestational diabetes mellitus (GDM) risk. We performed a nested case-control study in the Tongji Birth Cohort. GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24-28 gestational weeks. Nine cholesterol metabolism markers were detected using gas chromatography-mass spectrometry. Conditional logistic regression models were conducted. A total of 444 pregnant women were matched in a 1:2 ratio. The cholestanol and β-sitosterol in cholesterol absorption markers presented negative associations with the risks of GDM (adjusted OR: 0.77, 95% CI: 0.61-0.96; adjusted OR: 0.80, 95% CI: 0.64-1.00). The desmosterol in cholesterol synthesis markers were positively associated with the risks of GDM (adjusted OR: 1.25, 95% CI: 1.00-1.56), similar in the ratios of cholesterol synthesis to absorption markers. After adjustment for insulin or HOMA-IR, these effects were reduced. In conclusion, higher cholesterol synthesis and lower cholesterol absorption marker levels in the first pregnancy are associated with a higher risk of GDM, and insulin resistance may play a vital role in this association.
本研究旨在探讨妊娠胆固醇代谢标志物与妊娠期糖尿病（GDM）风险的关联。我们在同济出生队列中进行了一项巢式病例对照研究。GDM 的诊断依据是 24-28 孕周 75 g 2 h 口服葡萄糖耐量试验（OGTT）。采用气相色谱-质谱法检测 9 种胆固醇代谢标志物。采用条件逻辑回归模型进行分析。共有 444 名孕妇按照 1:2 的比例进行匹配。胆固醇吸收标志物中的胆甾烷醇和β-谷甾醇与 GDM 风险呈负相关（调整后的 OR：0.77，95%CI：0.61-0.96；调整后的 OR：0.80，95%CI：0.64-1.00）。胆固醇合成标志物中的去甲胆固醇与 GDM 风险呈正相关（调整后的 OR：1.25，95%CI：1.00-1.56），胆固醇合成与吸收标志物的比值相似。调整胰岛素或 HOMA-IR 后，这些影响有所减弱。总之，妊娠早期胆固醇合成升高和胆固醇吸收标志物水平降低与 GDM 风险增加相关，胰岛素抵抗可能在这种关联中起重要作用。
