BackgroundAlthough there is strong evidence linking triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio to insulin resistance and diabetes mellitus, its clinical importance in pregnant women has not been well determined. This study sought to determine the connection between the TG/HDL-C ratio in the first trimester and the eventual onset of gestational diabetes mellitus (GDM).MethodsWe performed a secondary analysis of open-access data from a prospective cohort study. This present study included 590 singleton pregnant women at 10-14 weeks who visited the outpatient clinics for prenatal checks and were recorded at Incheon Seoul Women’s Hospital and Seoul Metropolitan Government Seoul National University Boramae Medical Center in Korea. A binary logistic regression model, a series of sensitivity analyses, and subgroup analysis were used to examine the relationship between TG/HDL-C ratio and incident GDM. A receiver operating characteristic (ROC) analysis was also conducted to assess the ability of the TG/HDL-C ratio to predict GDM.ResultsThe mean age of the included individuals was 32.06 ± 3.80 years old. The mean TG/HDL-C ratio was 1.96 ± 1.09. The incidence rate of GDM was 6.27%. After adjustment for potentially confounding variables, TG/HDL-C ratio was positively associated with incident GDM (OR=1.77, 95%CI: 1.32-2.38, P=0.0001). Sensitivity analyses and subgroup analysis demonstrated the validity of the relationship between the TG/HDL-C ratio and GDM. The TG/HDL-C ratio was a good predictor of GDM, with an area under the ROC curve of 0.7863 (95% CI: 0.7090-0.8637). The optimal TG/HDL-C ratio cut-off value for detecting GDM was 2.2684, with a sensitivity of 72.97% and specificity of 75.05%.ConclusionOur results demonstrate that the elevated TG/HDL-C ratio is related to incident GDM. The TG/HDL-C ratio at 10-14 weeks could help identify pregnant women at risk for GDM and may make it possible for them to receive early and effective treatment to improve their prognosis.

Background Lipid metabolism disorder during pregnancy has been reported in women with gestational diabetes mellitus (GDM). However, controversy remains regarding the relationship between maternal changes in lipid profiles and perinatal outcomes. This study investigated the association between maternal lipid levels and adverse perinatal outcomes in women with GDM and non-GDM. Methods In total, 1632 pregnant women with GDM and 9067 women with non-GDM who delivered between 2011–2021 were enrolled in this study. Serum samples were assayed for fasting total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels during the second and third trimesters of pregnancy. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated via multivariable logistic regression analysis to determine the association of lipid levels with perinatal outcomes. Results The serum TC, TG, LDL, and HDL levels in the third trimester were significantly higher than those in the second trimester (p < 0.001). Women with GDM had significantly higher levels of TC and TG in the second and third trimesters than those with non-GDM in the same trimesters, while HDL levels decreased in women with GDM (all p < 0.001). After adjusting for confounding factors by multivariate logistic regression, every mmol/L elevation in TG levels of women with GDM in second and third trimesters was associated with a higher risk of caesarean section (AOR = 1.241, 95% CI: 1.103–1.396, p < 0.001; AOR = 1.716, 95% CI: 1.556–1.921, p < 0.001), large for gestational age infants (LGA) (AOR = 1.419, 95% CI: 1.173–2.453, p = 0.001; AOR = 2.011, 95% CI: 1.673–2.735, p < 0.001), macrosomia (AOR = 1.220, 95% CI: 1.133–1.643, p = 0.005; AOR = 1.891, 95% CI: 1.322–2.519, p < 0.001), and neonatal unit admission (NUD; AOR = 1.781, 95% CI: 1.267–2.143, p < 0.001; AOR = 2.052, 95% CI: 1.811–2.432, p < 0.001) cesarean delivery (AOR = 1.423, 95% CI: 1.215–1.679, p < 0.001; AOR = 1.834, 95% CI: 1.453–2.019, p < 0.001), LGA (AOR = 1.593, 95% CI: 1.235–2.518, p = 0.004; AOR = 2.326, 95% CI: 1.728–2.914, p < 0.001), macrosomia (AOR = 1.346, 95% CI: 1.209–1.735, p = 0.006; AOR = 2.032, 95% CI: 1.503–2.627, p < 0.001), and neonatal unit admission (NUD) (AOR = 1.936, 95% CI: 1.453–2.546, p < 0.001; AOR = 1.993, 95% CI: 1.724–2.517, p < 0.001), which were higher than the relative risk of these perinatal outcomes in women with non-GDM. Additionally, every mmol/L increase in second and third-trimester HDL levels of women with GDM was associated with decreased risk of LGA(AOR = 0.421, 95% CI: 0.353–0.712, p = 0.007; AOR = 0.525, 95% CI: 0.319–0.832, p = 0.017) and NUD (AOR = 0.532, 95% CI: 0.327–0.773, p = 0.011; AOR = 0.319, 95% CI: 0.193–0.508, p < 0.001), and the risk reduction was not strong than that of women with GDM. Conclusions Among women with GDM, high maternal TG in the second and third trimesters was independently associated with an increased risk of cesarean section, LGA, macrosomia, and NUD. High maternal HDL during the second and third trimesters was significantly associated with decreased risk of LGA and NUD. These associations were stronger than those in women with non-GDM, suggesting the importance of monitoring second and third-trimester lipid profiles in improving clinical outcomes, especially in GDM pregnancies.

Background: Lipid metabolism disorder during pregnancy has been reported in women with gestational diabetes mellitus (GDM). However, some controversy remains regarding the relationship between maternal dyslipidemia and perinatal outcomes. The aim of this study was to investigate the association between maternal lipid levels and adverse perinatal outcomes in women with GDM. Methods: Total 1755 pregnant women with GDM who delivered between 2011–2021 were enrolled in this study. Serum samples were assayed for fasting total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels during the second and third trimesters of pregnancy. Adjusted odds ratios (AOR) and 95% confidence intervals (95 % CI) were calculated via stepwise multivariable logistic regression analysis to determine the association of lipid levels with perinatal outcomes. Results: The serum TC, TG, LDL, and HDL levels in third trimester were significantly higher than those in second trimester(p<0.001). Women with GDM had significantly higher levels of TC and TG in second and third trimesters compared with women without GDM in the same trimesters, while HDL levels decreased in women with GDM. After adjusting for confounding factors by multivariate logistic regression, every mmol/L elevation in TG levels in second and third trimesters was associated with a higher risk of caesarean section(AOR=1.241, 95% CI: 1.103–1.396, p<0.001; AOR=1.716, 95% CI: 1.556–1.921, p<0.001), large for gestational age infants (AOR=1.419, 95% CI: 1.173–2.453, p=0.001; AOR=2.011, 95% CI: 1.673–2.735, p<0.001), macrosomia (AOR=1.220, 95%CI: 1.133–1.643, p=0.005; AOR=1.891, 95% CI: 1.322–2.519, p<0.001), and neonatal unit admission (AOR=1.781, 95% CI: 1.267–2.143, p<0.001; AOR=2.052, 95% CI: 1.811–2.432, p<0.001). Additionally, every mmol/L increase in second and third trimester HDL levels was associated with decreased risk of large for gestational age infants (AOR=0.478, 95% CI: 0.329–0.879, p=0.008; AOR=0.599, 95% CI: 0.321–0.783, p=0.017) and neonatal unit admission (AOR=0.575, 95% CI: 0.311–0.722, p=0.012; AOR=0.322, 95% CI: 0.178–0.599, p=0.001). Conclusions: Among women with GDM, dyslipidemia in second and third trimesters was related to adverse perinatal outcomes, suggesting the importanceof monitoring second and third trimester lipid profiles in improving clinical outcomes in GDM pregnancies.