Wang Jing, Li Zhi, Lin Li
Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China.
Medicine (Baltimore). 2019 Apr;98(16):e15320. doi: 10.1097/MD.0000000000015320.
To determine the longitude lipid profiles in women with and without gestational diabetes mellitus (GDM), and to investigate the relationship between lipid disturbances in the 1st trimester and GDM.Blood samples were collected from 1283 normal pregnant women and 300 women with GDM. Serum lipids which include total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured and the TG/HDL-C ratio was calculated in the 1st, 2nd, and 3rd trimesters of pregnancy and then we got the longitudinal lipid profiles. We compared the differences of lipid profiles between patients with GDM and normal pregnant women using 2-way repeated measures analysis of variance. Also additional propensity-based subgroup analyses were performed. The logistic regression analysis was used to determine the relationship between the lipid disturbances in the 1st trimester and GDM.TG, TC, LDL-C concentrations, and TG/HDL-C ratio increased progressively throughout pregnancy; while HDL-C amounts increased from the 1st to the 2nd trimester with a slight decrease in the 3rd trimester. The GDM group showed higher TG concentrations, higher TG/HDL-C ratio, and lower HDL-C concentrations throughout pregnancy. There were no significant differences in TC and LDL-C concentrations in the 1st, 2nd, and 3rd trimesters (P > .05), between the GDM group and the control group. Logistic regression analysis showed that maternal age, prepregnancy body mass index (BMI), and TG/HDL ratio in the 1st trimester were associated with an increased risk of GDM.The lipid profile alters significantly in patients with GDM, and maternal age, prepregnancy BMI, and TG/HDL ratio in the 1st trimester were associated with an increased risk of GDM.
确定患有和未患有妊娠期糖尿病(GDM)的女性的纵向血脂谱,并研究孕早期血脂紊乱与GDM之间的关系。收集了1283名正常孕妇和300名患有GDM的女性的血样。在妊娠的第1、2和3个 trimester测量了包括总胆固醇(TC)、甘油三酯(TGs)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)在内的血脂,并计算了TG/HDL-C比值,从而得到纵向血脂谱。我们使用双向重复测量方差分析比较了GDM患者和正常孕妇血脂谱的差异。还进行了基于倾向得分的亚组分析。使用逻辑回归分析来确定孕早期血脂紊乱与GDM之间的关系。TG、TC、LDL-C浓度和TG/HDL-C比值在整个孕期逐渐升高;而HDL-C含量从第1孕期到第2孕期增加,在第3孕期略有下降。GDM组在整个孕期显示出更高的TG浓度、更高的TG/HDL-C比值和更低的HDL-C浓度。在第1、2和3孕期,GDM组和对照组之间的TC和LDL-C浓度没有显著差异(P>0.05)。逻辑回归分析表明,母亲年龄、孕前体重指数(BMI)和孕早期的TG/HDL比值与GDM风险增加相关。GDM患者的血脂谱有显著改变,母亲年龄、孕前BMI和孕早期的TG/HDL比值与GDM风险增加相关。