Postpartum dyslipidemia and the potential predictors in women with history of gestational diabetes mellitus

Abstract

Aims/Introduction: To analyze the incidence of early postpartum dyslipidemia and the potential predictors among women with history of gestational diabetes mellitus (GDM).Materials and Methods: This was a retrospective study. 589 women diagnosed with GDM were recruited and followed up at 6-12 weeks after delivery. The general demographic and metabolic data during pregnancy were collected. Participants were divided into the normal lipid group and dyslipidemia group according to the postpartum lipid level. Demographic and metabolic parameters were compared. Multivariate logistic regression was performed to analyze the potential predictors for the early postpartum dyslipidemia. Receiver operating characteristic (ROC) curve was conducted to determine the cut-off values.Results: 38.5% of the 589 women developed dyslipidemia in early postpartum and 60% of them had normal glucose metabolism. Delivery age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of early postpartum dyslipidemia in women with history of GDM. The cut-offs of maternal age, SBP, HbA1c and LDL-C were 35 years, 5.1% and 3.56 mmol/L, respectively. LDL-C achieved a balanced mix of high sensitivity（63.9%）and specificity(69.2%）with highest area under the receiver operating characteristic curve（AUC) (0.696). When LDL-C was combined with age, SBP and HbA1c, the AUC reached to 0.733.Conclusions: Women with history of GDM should be screened lipid metabolism after delivery, particularly those with maternal age >35 years, SBP>123mmHg before labor, HbA1c>5.1%, or LDL-C>3.56mmol/L in the second trimester of pregnancy.