Skip to main content
Log in

Early Pregnancy Maternal Lipid Profiles and the Risk of Gestational Diabetes Mellitus Stratified for Body Mass Index

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

Objective

To determine associations between lipid profiles in early pregnancy stratified by body mass index (BMI) and risk of developing gestational diabetes mellitus (GDM).

Study Design

A total of 2488 healthy pregnant women were enrolled prospectively. Fasting plasma lipid profiles were measured at mean 11 weeks of gestation including triglycerides (TGs), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and cholesterol (CHO). We assessed early pregnancy maternal lipid concentrations in different tertiles in association with the risk of GDM stratified for BMI. Multivariable logistic regression analyses were used to estimate the relative risk of GDM by calculating odds ratios and 95% confidence intervals (CIs).

Results

In univariate analyses, pregnant women with GDM had significantly increased serum TG, CHO, LDL concentrations, LDL/HDL ratio, and decreased LDL concentrations, compared to control groups, each P < .01, respectively. After adjustment for confounders, there was a 1.8-fold increase in risk for GDM in the lean group (95% CI: 1.2–2.7) and 2.7-fold increase in the obese group (95% CI: 1.1–6.6), respectively, if TG ≥ 1.58 mmol/L. About a 50% decrease in the risk of GDM was observed in lean women with HDL ≥ 2.22 mmol/L (95% CI: 0.3–0.9). No significant correlations of other lipid profiles with the risk of developing GDM were observed.

Conclusion

Early pregnancy dyslipidemia is associated with the risk of developing GDM. Lean or obese women with higher TG concentrations are at an increased risk for developing GDM while lean women with high HDL are protected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Metzger BE, Lowe LP, Dyer AR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19): 1991–2002.

    Article  Google Scholar 

  2. Gilmartin AB, Ural SH, Repke JT. Gestational diabetes mellitus. Rev Obstet Gynecol. 2008;1(3):129–134.

    PubMed  Google Scholar 

  3. Enquobahrie DA, Williams MA, Qiu C, Luthy DA. Early pregnancy lipid concentrations and the risk of gestational diabetes mellitus. Diabetes Res Clin Pract. 2005;70(2):134–142.

    Article  CAS  Google Scholar 

  4. Di Cianni G, Miccoli R, Volpe L, Lencioni C, Del Prato S. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003;19(4):259–270.

    Article  Google Scholar 

  5. Buchanan TA. Pancreatic B-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endocrinol Metab. 2001;86(3):989–993.

    Article  CAS  Google Scholar 

  6. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004;27(6):1496–1504.

    Article  CAS  Google Scholar 

  7. Emet T, Ustuner I, Guven SG, et al. Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes. Arch Gynecol Obstet. 2013;288(1):49–55.

    Article  CAS  Google Scholar 

  8. Wiznitzer A, Mayer A, Novack V, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2009; 201(5):482.e1–482.e8.

    Article  Google Scholar 

  9. Alvarez JJ, Montelongo A, Iglesias A, Lasuncion MA, Herrera E. Longitudinal study on lipoprotein profile, high density lipoprotein subclass, and postheparin lipases during gestation in women. J Lipid Res. 1996;37(2):299–308.

    CAS  PubMed  Google Scholar 

  10. Zhou B. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population [in Chinese]. Zhonghua Liu Xing Bing Xue Za Zhi. 2002; 23(3):5–10.

    PubMed  Google Scholar 

  11. American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 2013;36(suppl 1):S11–S66.

    Article  Google Scholar 

  12. Savvidou M, Nelson SM, Makgoba M, Messow CM, Sattar N, Nicolaides K. First-trimester prediction of gestational diabetes mellitus: examining the potential of combining maternal characteristics and laboratory measures. Diabetes. 2010;59(12): 3017–3022.

    Article  CAS  Google Scholar 

  13. Bower JF, Hadi H, Barakat HA. Plasma lipoprotein subpopulation distribution in Caucasian and African-American women with gestational diabetes. Diabetes Care. 2001;24(1):169–171.

    Article  CAS  Google Scholar 

  14. Clark CM Jr, Qiu C, Amerman B, et al. Gestational diabetes: should it be added to the syndrome of insulin resistance? Diabetes Care. 1997;20(5):867–871.

    Article  Google Scholar 

  15. Nolan CJ, Riley SF, Sheedy MT, Walstab JE, Beischer NA. Maternal serum triglyceride, glucose tolerance, and neonatal birth weight ratio in pregnancy. Diabetes Care. 1995;18(12):1550–1556.

    Article  CAS  Google Scholar 

  16. Sanchez-Vera I, Bonet B, Viana M, et al. Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation in pregnancies complicated by gestational diabetes: consequences of obesity. Metabolism. 2007;56(11):1527–1533.

    Article  CAS  Google Scholar 

  17. Bartha JL, Comino-Delgado R, Martinez-Del-Fresno P, Fernandez-Barrios M, Bethencourt I, Moreno-Corral L. Insulin-sensitivity index and carbohydrate and lipid metabolism in gestational diabetes. J Reprod Med. 2000;45(3):185–189.

    CAS  PubMed  Google Scholar 

  18. Montelongo A, Lasuncion MA, Pallardo LF, Herrera E. Longitudinal study of plasma lipoproteins and hormones during pregnancy in normal and diabetic women. Diabetes. 1992;41(12): 1651–1659.

    Article  CAS  Google Scholar 

  19. Marseille-Tremblay C, Ethier-Chiasson M, Forest JC, et al. Impact of maternal circulating cholesterol and gestational diabetes mellitus on lipid metabolism in human term placenta. Mol Reprod Dev. 2008;75(6): 1054–1062.

    Article  CAS  Google Scholar 

  20. Rizzo M, Berneis K, Altinova AE, et al. Atherogenic lipoprotein phenotype and LDL size and subclasses in women with gestational diabetes. Diabet Med. 2008;25(12):1406–1411.

    Article  CAS  Google Scholar 

  21. Connor Gorber S, Tremblay M, Moher D, Gorber B. A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007;8(4): 307–326.

    Article  CAS  Google Scholar 

  22. Hurt-Camejo E, Camejo G, Rosengren B, et al. Effect of arterial proteoglycans and glycosaminoglycans on low density lipoprotein oxidation and its uptake by human macrophages and arterial smooth muscle cells. Arterioscler Thromb. 1992;12(5):569–583.

    Article  CAS  Google Scholar 

  23. Kajimoto Y, Kaneto H. Role of oxidative stress in pancreatic betacell dysfunction. Ann N Y Acad Sci. 2004;1011(4):168–176.

    Article  CAS  Google Scholar 

  24. Wajchenberg BL. Beta-cell failure in diabetes and preservation by clinical treatment. Endocr Rev. 2007;28(2): 187–218.

    Article  CAS  Google Scholar 

  25. Robertson RP, Harmon J, Tran PO, Poitout V. Beta-cell glucose toxicity, lipotoxicity, and chronic oxidative stress in type 2 diabetes. Diabetes. 2004;53(suppl 1):S119–S124.

    Article  CAS  Google Scholar 

  26. Van Raalte DH, Diamant M. Glucolipotoxicity and beta cells in type 2 diabetes mellitus: target for durable therapy? Diabetes Res Clin Pract. 2011;93(suppl 1):S37–S46.

    Article  Google Scholar 

  27. Robertson RP, Harmon J, Tran PO, Tanaka Y, Takahashi H. Glucose toxicity in beta-cells: type 2 diabetes, good radicals gone bad, and the glutathione connection. Diabetes. 2003; 52(3):581–587.

    Article  CAS  Google Scholar 

  28. Kelley DE, Goodpaster BH. Skeletal muscle triglyceride. An aspect of regional adiposity and insulin resistance. Diabetes Care. 2001;24(5):933–941.

    Article  CAS  Google Scholar 

  29. Abderrahmani A, Niederhauser G, Favre D, et al. Human highdensity lipoprotein particles prevent activation of the JNK pathway induced by human oxidised low-density lipoprotein particles in pancreatic beta cells. Diabetologia. 2007;50(6):1304–1314.

    Article  CAS  Google Scholar 

  30. Ghio A, Bertolotto A, Resi V, Volpe L, Di Cianni G. Triglyceride metabolism in pregnancy. Adv Clin Chem. 2011;55:133–153.

    Article  CAS  Google Scholar 

  31. Basaran A. Pregnancy-induced hyperlipoproteinemia: review of the literature. Reprod Sci. 2009;16(5):431–437.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Weiyuan Zhang MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, G., Kong, L., Zhang, L. et al. Early Pregnancy Maternal Lipid Profiles and the Risk of Gestational Diabetes Mellitus Stratified for Body Mass Index. Reprod. Sci. 22, 712–717 (2015). https://doi.org/10.1177/1933719114557896

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719114557896

Keywords

Navigation