Liu Yvonne, Hocher Johann-Georg, Ma Shujuan, Hu Liang, Chen Huijun, Zhang Xiaoli, Gong Fei, Krämer Bernhard K, Lin Ge, Hocher Berthold
Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167, Mannheim, Germany.
Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China.
Reprod Biol Endocrinol. 2024 Dec 5;22(1):155. doi: 10.1186/s12958-024-01320-9.
BACKGROUND & OBJECTIVE: To analyze whether there is an association between pre-pregnancy lipid parameters and gestational diabetes mellitus (GDM) in women undergoing assisted reproductive technologies (ART), a group especially at risk for GDM, and if so, which parameter is associated the strongest.
Data was collected at the Reproductive and Genetic Hospital CITIC-Xiangya in Changsha, China from January 2017 to December 2018. The measured lipid parameters include LDL (low-density lipoprotein), HDL (high-density lipoprotein), TC (total cholesterol), and TG (triglycerides).
119 (15.5%) of the 767 patients developed GDM. On average, women who developed GDM were older, had a higher BMI, LDL, TC, and TG, and lower HDL. After adjusting for confounders, LDL and HDL showed a significant association with GDM (p < 0.05), but TC and TG did not. Binary LDL/HDL and TC/HDL ratios showed the strongest association with GDM incidence (OR 1.957 [95%CI 1.258-3.044] and 1.942 [1.243-3.034] respectively). Subgroup analysis showed that an elevated LDL/HDL ratio also increased GDM risk in subgroups with a typically lower prevalence of GDM, such as young women with a low BMI and low blood pressure. Both lipid ratios (LDL/HDL and TC/HD) show strong interactions with baseline age, fasting plasma glucose, and LH.
In this cohort of Chinese women undergoing ART, pre-pregnancy LDL/HDL and TC/HDL were associated with GDM the strongest from the lipid parameters and could be useful to estimate GDM risk even before ART treatments and pregnancy.
NCT03503006 registered on the 21st of March 2018 (on clinicaltrials.gov). https://clinicaltrials.gov/study/NCT03503006?locStr=Changsha,%20Hunan,%20China&country=China&state=Hunan&city=Changsha&cond=ivf&rank=2 .
分析接受辅助生殖技术（ART）的女性（这是患妊娠期糖尿病（GDM）风险特别高的群体）孕前血脂参数与GDM之间是否存在关联，若存在关联，哪种参数的关联性最强。
于2017年1月至2018年12月在中国长沙中信湘雅生殖与遗传专科医院收集数据。所测血脂参数包括低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、总胆固醇（TC）和甘油三酯（TG）。
767例患者中有119例（15.5%）发生GDM。平均而言，发生GDM的女性年龄更大，体重指数、LDL、TC和TG更高，而HDL更低。在对混杂因素进行校正后，LDL和HDL与GDM存在显著关联（p<0.05），但TC和TG不存在。二元LDL/HDL和TC/HDL比值与GDM发生率的关联性最强（OR分别为1.957[95%CI 1.258 - 3.044]和1.942[1.243 - 3.034]）。亚组分析表明，在GDM患病率通常较低的亚组中，如低体重指数和低血压的年轻女性，LDL/HDL比值升高也会增加GDM风险。两种血脂比值（LDL/HDL和TC/HD）均与基线年龄、空腹血糖和促黄体生成素存在强烈交互作用。
在这一接受ART的中国女性队列中，从血脂参数来看，孕前LDL/HDL和TC/HDL与GDM的关联性最强，甚至在ART治疗和怀孕前就可能有助于评估GDM风险。
2018年3月21日在clinicaltrials.gov上注册的NCT03503006。https://clinicaltrials.gov/study/NCT03503006?locStr=Changsha,%20Hunan,%20China&country=China&state=Hunan&city=Changsha&cond=ivf&rank=2 。
