Plasma concentrations of lipids during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study

Background Abnormal lipid profiles have been associated with gestational diabetes mellitus (GDM), but studies with longitudinal measures of lipids throughout pregnancy are sparse. The aim of the present study was to characterize longitudinal changes in lipid profiles throughout pregnancy and prospectively examine the associations of plasma lipid concentrations with risk of GDM. Methods This study was a nested case‐control study including 107 GDM cases and 214 matched non‐GDM controls from participants in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies – Singleton cohort. Blood samples were collected longitudinally at Gestational Weeks (GW) 10–14, 15–26 (fasting sample), 23–31, and 33–39. Plasma concentrations of triglycerides, total cholesterol, and high‐density lipoprotein cholesterol (HDL‐C) were measured by enzymatic assays. Low‐density lipoprotein cholesterol (LDL‐C) was calculated using Friedewald's formula. Results Plasma triglycerides, total cholesterol, and LDL‐C increased as pregnancy progressed. At GW 10–14, the adjusted odds ratios (aORs) of GDM comparing the highest versus lowest quartile were 3.15 (95% confidence interval [CI] 1.38–7.15; P trend = 0.002) for triglycerides and 0.44 (95% CI 0.18–1.09; P trend = 0.045) for HDL‐C. At GW 15–26, the aORs were 6.57 (95% CI 2.25–19.17; P trend = 0.001) for triglycerides and 0.23 (95% CI 0.08–0.63; P trend = 0.005) for HDL‐C. No significant associations were observed for total cholesterol and LDL‐C concentrations with risk of GDM. Conclusions Higher plasma triglyceride and lower HDL‐C concentrations in early and mid‐pregnancy were significantly associated with a greater risk of GDM. Total cholesterol and LDL‐C concentrations during pregnancy were not significantly associated with GDM risk. 摘要 背景 目前已经有研究证实血脂异常与妊娠糖尿病(gestational diabetes mellitus, GDM)相关, 但是很少有研究对整个妊娠期间的血脂进行纵向测量。当前这项研究的目的是描述整个妊娠期间血脂谱的纵向变化特征, 并且前瞻性地调查了血脂浓度与GDM风险之间的关系。 方法 这项研究是一项巢式病例对照研究, 纳入的参与者来自于全国儿童健康与人类发展研究所(National Institute of Child Health and Human Development, NICHD)主持的胎儿生长研究‐独生子女队列研究, 包括107名GDM患者以及214名匹配的非GDM对照组受试者。纵向收集孕周为第10‐14、15‐26(空腹血)、23‐31以及33‐39周时的血样。用酶法测定血浆中的三酰甘油、总胆固醇以及高密度脂蛋白胆固醇(HDL‐C)的浓度。使用FrieDeWald公式来计算低密度脂蛋白胆固醇(LDL‐C)。 结果 血浆中的三酰甘油、总胆固醇以及LDL‐C水平随着孕周的增加而上升。在孕10‐14周时, 三酰甘油的最高与最低四分位数组相比, 校正后的GDM危险比(adjusted odds ratios, aORs)为3.15(95%置信区间[CI]为1.38‐7.15;Ptrend = 0.002), HDL‐C则为0.44(95% CI为0.18‐1.09;Ptrend = 0.045)。在孕15‐26周时, 三酰甘油最高与最低四分位数组相比的aORs为6.57(95% CI为2.25‐19.17;P