Gestational hypertriglyceridemia and adverse pregnancy outcomes: A search for cutoffs using generalized additive models

Chen, Szu-Chieh; Lee, Chien‐Nan; Hu, Fu‐Chang; Kuo, Chun‐Heng; Lin, Ming-Chia; Chen, Kuan‐Yu; Tai, Yi-Yun; Lin, Chang-Pin; Yen, I-Weng; Lin, Shuo; Li, Chung‐Yi

doi:10.1016/j.diabres.2022.109820

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…This flexibility allows for the graphical evaluation of the curve shape and identification of cutoff points by analyzing inflection points. The GAM approach has been used for cutoff point definition in different studies (20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models

et al. 2023

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BackgroundObesity is associated with premature mortality in adults; however, this association has been inconsistent in the older adult population. In addition, there is a lack of specific cutoff points for indicators of negative health outcomes in older adults. Methods: This is a prospective study with 796 non-institutionalized older adults. Data on sociodemographic characteristics, lifestyle, food consumption, and nutritional status were obtained at baseline. Generalized additive models were used to identify cutoff points for the waist circumference (WC) and waist-to-height ratio (WHtR) and Cox proportional hazards models to assess the independent association between adiposity and mortality.ResultsOver the 9 years of follow-up, 197 deaths (24.7%) occurred, of which 51.8% were men, with a mean age of 76.1 ± 9.0 years. Older adults at higher risk of death had WHtR of <0.52 or ≥0.63 and WC of <83 cm or ≥101 cm. An increased risk of death was observed in older adults with high WC (HR: 2.03 95% CI: 1.20–3.41) and high WHtR (HR: 1.51 95% CI: 1.01–2.26) in the adjusted models, and an increase in WC was a risk factor for higher CVD mortality (HR: 2.09, 95% CI: 1.12–3.88) in the adjusted models.ConclusionAdiposity was associated with an increased risk of death in older adults. In view of these results and considering the lack of cutoff points for anthropometric indices in Brazilian older adults, further studies are needed to confirm the WC and WHtR cutoff values found in this study.

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Section: Discussionmentioning

confidence: 99%

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models

et al. 2023

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“…Severe hypertriglyceridemia, often linked to secondary causes such as diabetes mellitus, can lead to rare but life‐threatening acute pancreatitis during pregnancy. In Taiwan, lipid profiles, especially triglyceride, should be checked during the first and second trimesters 86 . Elevated triglyceride levels (>140 mg/dL in the first trimester or >220 mg/dL in the second trimester) necessitate monthly monitoring and lifestyle adjustments.…”

Section: Management Of Dyslipidemia In Special Populations With Diabe...mentioning

confidence: 99%

Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators

Shen,

Chu,

Chen

et al. 2024

J of Diabetes Invest

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We present an in‐depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low‐density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence‐based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes.

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“… 21–29 Most of these studies are from Asia and Europe and used different methods to define normal ranges, albeit most used the population distribution curve. Only one study by Chen et al 29 . defined the normal ranges based on the risk of gestational diabetes mellitus (GDM).…”

Section: Normal Physiology Of Lipids In Pregnancymentioning

confidence: 99%

“…20 Only a few studies have been undertaken to define the normal ranges of TG in pregnancy (Table 1). [21][22][23][24][25][26][27][28][29] Most of these studies are from Asia and Europe and used different methods to define normal ranges, albeit most used the population distribution curve. Only one study by Chen et al 29 defined the normal ranges based on the risk of gestational diabetes mellitus (GDM).…”

Section: Normal Physiology Of Lipids In Pregnancymentioning

confidence: 99%

“…[21][22][23][24][25][26][27][28][29] Most of these studies are from Asia and Europe and used different methods to define normal ranges, albeit most used the population distribution curve. Only one study by Chen et al 29 defined the normal ranges based on the risk of gestational diabetes mellitus (GDM). Regardless of the methods, almost all the studies showed a rise in TG levels across the three trimesters.…”

Section: Normal Physiology Of Lipids In Pregnancymentioning

confidence: 99%

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Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy

Bashir

Navti

Ahmed

et al. 2023

The Obstetric & Gynaecologis

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Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy-specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). HC and sHTG are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre-eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/ modification, omega-3, bile-acid sequestrants, fenofibrate, statins and plasmapheresis. Learning objectivesTo understand the physiological changes that occur in lipids in pregnancy and how these are modulated. To appreciate the importance of severe HC and HTG in pregnancy, including their effects on maternal morbidity and mortality. To understand the various approaches to management and the importance of multidisciplinary management. Ethical issuesShould every woman be screened for HTG and HC during pregnancy? How safe are statins and other treatments for lipid disorders in pregnancy? Should women with very severe HTG be discouraged from getting pregnant?

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Gestational hypertriglyceridemia and adverse pregnancy outcomes: A search for cutoffs using generalized additive models

Cited by 6 publications

References 31 publications

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models

Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators

Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy

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