Sheng Jing, Ma Chun-Fang, Wu Xiao-Fei, Li Xiang-Xiang
Department of Clinical Laboratory, Suzhou Ninth People's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China.
Department of Emergency Medicine, Suzhou Ninth People's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China.
PLoS One. 2025 Jan 3;20(1):e0316934. doi: 10.1371/journal.pone.0316934. eCollection 2025.
There is no evidence to suggest that an association exists between the remnant cholesterol (RC) to high-density lipoprotein cholesterol (HDL-C) ratio and gestational diabetes mellitus (GDM). In this study, the RC/HDL-C ratio during the first trimester was examined as a potential indicator of the onset of GDM during the second trimester.
This was a secondary analysis of data from a Korea-based prospective cohort study. The study involved 582 women within 14 weeks of pregnancy who were examined between November 2014 and July 2016 at two Korean hospitals. RC was calculated as total cholesterol (TC) minus the sum of low-density lipoprotein cholesterol (LDL-C) and HDL-C. The RC/HDL-C ratio was determined by dividing the RC content by the HDL-C content. The RC/HDL-C ratio and GDM occurrence were investigated utilizing a binary logistic regression model, various sensitivity analyses, and subgroup analyses. Additionally, the RC/HDL-C ratio was evaluated using receiver operating characteristic (ROC) analysis.
The average age of the pregnant women was 32.07 ± 3.78 years, and the RC/HDL-C ratio had a median value of 0.39. The prevalence of GDM was 6.01%. There was a positive association between the RC/HDL-C ratio and the incidence of GDM after adjusting for potential confounding variables (odds ratio: 21.78, 95% confidence interval [CI]: 3.55-133.73, P < 0.001). Furthermore, this association was validated by subgroup and sensitivity analyses. The results indicated that the RC/HDL-C ratio was a robust predictor of GDM, with an area under the ROC curve of 0.795 (95% CI: 0.723-0.868). The optimal threshold value was 0.45, with a sensitivity of 71.4% and a specificity of 75.3%. Compared with traditional lipid markers, including LDL-C, HDL-C, triglycerides, TC, and the emerging marker RC, the RC/HDL-C exhibited higher diagnostic efficacy.
There is an increased risk of GDM associated with higher levels of the RC/HDL-C ratio between 12 and 14 weeks of gestation, independent of traditional risk factors. The RC/HDL-C ratio is more effective in diagnosing GDM than traditional lipid markers.
尚无证据表明残余胆固醇（RC）与高密度脂蛋白胆固醇（HDL-C）的比值与妊娠期糖尿病（GDM）之间存在关联。在本研究中，对孕早期的RC/HDL-C比值进行检测，以作为孕中期发生GDM的潜在指标。
这是一项对韩国前瞻性队列研究数据的二次分析。该研究纳入了582名妊娠14周内的女性，她们于2014年11月至2016年7月在韩国两家医院接受检查。RC的计算方法为总胆固醇（TC）减去低密度脂蛋白胆固醇（LDL-C）与HDL-C之和。RC/HDL-C比值通过RC含量除以HDL-C含量来确定。利用二元逻辑回归模型、各种敏感性分析和亚组分析来研究RC/HDL-C比值与GDM发生情况。此外，使用受试者工作特征（ROC）分析来评估RC/HDL-C比值。
孕妇的平均年龄为32.07±3.78岁，RC/HDL-C比值的中位数为0.39。GDM的患病率为6.01%。在调整潜在混杂变量后，RC/HDL-C比值与GDM的发病率呈正相关（比值比：21.78，95%置信区间[CI]：3.55 - 133.73，P < 0.001）。此外，该关联通过亚组和敏感性分析得到验证。结果表明，RC/HDL-C比值是GDM的可靠预测指标，ROC曲线下面积为0.795（95% CI：0.723 - 0.868）。最佳阈值为0.45，敏感性为71.4%，特异性为75.3%。与传统脂质标志物（包括LDL-C、HDL-C、甘油三酯、TC）以及新兴标志物RC相比，RC/HDL-C具有更高的诊断效能。
在妊娠12至14周时，RC/HDL-C比值升高与GDM风险增加相关，且独立于传统风险因素。RC/HDL-C比值在诊断GDM方面比传统脂质标志物更有效。
