The relationship between total cholesterol and postpartum impaired glucose tolerance in women with gestational diabetes mellitus

Wang, Dongyu; Ding, Wenjiang; Xu, Shuqia; Chen, Haitian; Liu, Bin; Wang, Zilian

doi:10.1186/s12944-020-01316-5

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…This was an unexpected finding, given that none of the women was taking cholesterol-lowering medication. Our finding is consistent with that of Wang et al [41] who found that lower total cholesterol at diagnosis of GDM related to an increased risk of postpartum abnormal glucose regulation. The possible reasons for lower cholesterol may relate to impaired synthesis as suggested by an in-vitro study showing that under hyperglycaemic conditions, cultured blastocysts exhibit reduced expression of both HMG-CoA reductase, and sterol regulatory element-binding transcription protein (SREBP) that regulate cholesterol synthesis [42].…”

Section: Discussionsupporting

confidence: 93%

Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia

Barden

Shinde

Phillips

et al. 2022

Journal of Hypertension

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Objective: Women with gestational diabetes (GDM) have an increased risk of preeclampsia and postpartum diabetes. Inflammation associates with both GDM and preeclampsia. This study examined specialized proresolving mediators (SPM) that direct inflammation resolution and eicosanoids that are involved in inflammation, in relation to the development of preeclampsia and ongoing postpartum glucose intolerance in GDM.Methods: Participants were selected from a prospective study examining the development of preeclampsia in women with GDM. Four groups of age-matched women were studied: GDM (n ¼ 20), GDM who developed preeclampsia (GDMRPE, n ¼ 21), GDM who remained glucose-intolerant postpartum (GDMRPPIGT, n ¼ 20), or pregnancies with glucose tolerance within the normal range (NGT, n ¼ 21). Measurement of SPM (E-series resolvins and D-series resolvins), SPM pathway intermediates (14-HDHA, 18-HEPE and 17-HDHA), 20hydroxyeicosatetraenoic acid (20-HETE), and the urinary metabolite of the vasodilator prostacyclin 2,3-dinor-6-Keto-PGF 1a , were made at 28, 32 and 36 weeks gestation and at 6 months postpartum.Results: Compared with GDM, GDMRPE had elevated levels of 20-HETE and the SPM pathway intermediates 14-HDHA, 18-HEPE, 17-HDHA, at 32 weeks, and the SPM RvE1 at 32 and 36 weeks gestation. Compared with NGT and regardless of whether they developed preeclampsia or PPIGT, GDM had lower levels of 2,3-dinor-6-Keto-PGF 1a during pregnancy. Conclusion: Reduced levels of the prostacyclin metabolite 2,3-dinor-6-Keto-PGF 1a may contribute to the increased risk of preeclampsia in women with GDM. The increase in 20-HETE, a vasoconstrictor and mediator of inflammation, and SPM that contribute to inflammation resolution, prior to the onset of preeclampsia require further investigation to clarify their clinical significance.

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Section: Discussionsupporting

confidence: 93%

Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia

Barden

Shinde

Phillips

et al. 2022

Journal of Hypertension

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“…However, it is possible that lower serum creatinine levels indicate decreased skeletal muscle mass, as hypothesized. In our study, women with GDM had a median pre-pregnancy BMI of just 21.5 kg/m 2 , and we discovered that early postpartum glucose metabolism disorder in these women primarily manifested as IGT rather than IFG, which is consistent with previous Asian studies [17,18,37]. Unlike individuals with IFG who are generally obese, accompanied by hepatorenal insulin resistance and elevated gluconeogenesis, individuals with IGT have reduced peripheral insulin sensitivity (mainly representing skeletal muscle), combined with impairments in glucosestimulated insulin secretion, resulting in postprandial hyperglycemia [38][39][40].…”

Section: Discussionsupporting

confidence: 91%

“…The characteristic of the postpartum AGM in Asian GDM women was higher postglucose challenge levels [16][17][18].We know that postprandial hyperglycemia is mainly associated with reduced glucose uptake (mainly representing muscle) combined with glucose-stimulated insulin secretion dysfunction. Skeletal muscle serves as a key player as the major site of postprandial glucose disposal, accounting for about 85% of glucose uptake [19].…”

Section: Introductionmentioning

confidence: 99%

Low Serum Creatinine Levels in Early Pregnancy Are Associated with a Higher Incidence of Postpartum Abnormal Glucose Metabolism among Women with Gestational Diabetes Mellitus: A Retrospective Cohort Study

Chen

Zeng

et al. 2023

Nutrients

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The predictive factors for the progression from gestational diabetes mellitus (GDM) to type 2 diabetes remain incompletely elucidated. Our objective was to investigate the link between serum creatinine, a proxy for skeletal muscle mass, and the development of postpartum abnormal glucose metabolism (AGM). Methods: A retrospective review of the medical records of 501 women with GDM was conducted, all of whom underwent a 75 g oral glucose tolerance test (OGTT) between 4 and 12 weeks postpartum. Women were grouped based on quartiles of serum creatinine at the first antenatal visit to estimate the association between serum creatinine and postpartum AGM incidence. Results: Compared with the highest quartile of creatinine, lower quartiles were substantially linked to an increased incidence of postpartum AGM (adjusted odds ratios 3.37 [95% CI 1.77–6.42], 2.42 [95% CI 1.29–4.51] and 2.27 [95% CI 1.23–4.18], respectively). The generalized additive model suggested a linear relationship between serum creatinine levels and the risk of postpartum AGM below 68 µmol/L of serum creatinine levels. A decrease of 2 μmol/L in serum creatinine levels was found to be associated with a 10% increase in the odds of developing postpartum AGM. Linear regression revealed that a low serum creatinine level was linked to a higher postpartum 2-h glucose level and a decreased insulinogenic index (p = 0.007 and p = 0.027, respectively). Conclusions: An association was observed between lower serum creatinine levels in early pregnancy and an increased risk of postpartum AGM and poorer β-cell function in women with a recent history of GDM. Further research is needed to understand the mechanisms underlying our findings, as well as the role of skeletal muscle mass or nutritional status in early pregnancy on later glucose metabolism.

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“…Another related study carried out by Pei Xiaocao and his team also found that GDM patients with abnormal postpartum glycometabolism were more likely to have higher TG and LDL-c in the second trimester [ 21 ]. However, GDM patients who located at low cholesterol quartiles at the time of GDM diagnosis were reported to have higher risk of abnormal glucose metabolism after delivery [ 22 ]. All of the above results indicated that the relationship between pregnancy lipid and postpartum glucose metabolism was yet to be fully revealed.…”

Section: Discussionmentioning

confidence: 99%

Association between lipid trajectories during pregnancy and risk of postpartum glucose intolerance after gestational diabetes mellitus: a cohort study

Yang

Cheng

et al. 2022

Acta Diabetol

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Aims To assess lipid trajectories throughout pregnancy in relation to early postpartum glucose intolerance in women with gestational diabetes mellitus (GDM). Methods This prospective cohort study included 221 Chinese women with GDM who completed plasma lipid test in each trimester of pregnancy and oral glucose tolerance test at 6–9 weeks postdelivery between January 1, 2018 and January 8, 2020. Using the group-based trajectory modeling, total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol(HDL-c) were identified separately as three trajectories: low, moderate, and high trajectory. The associations between lipid trajectories and early postpartum glucose intolerance were all evaluated. Results Seventy-three participants developed postpartum glucose intolerance. For patients in low, moderate and high trajectory, the incidence of postpartum glucose intolerance was 38.4%, 34.9%, and 17.9%, respectively. GDM women with lower LDL-c trajectories presented a higher risk of postpartum glucose intolerance. The adjusted odds ratio (95% CI) for glucose intolerance was 3.14 (1.17–8.39) in low LDL-c trajectory and 2.68 (1.05–6.85) in moderate trajectory when compared with the high one. However, TC trajectory was not associated with the risk of postpartum glucose intolerance, nor were TG trajectory and HDL-c trajectory. Moreover, a significant difference of insulin sensitivity was observed in participants with different LDL-c trajectories; participants in high LDL-c trajectory had the highest insulin sensitivity, whereas the women in low LDL-c trajectory had the lowest insulin sensitivity (P = 0.02). Conclusions The high trajectory of LDL-c during pregnancy may play a protective role on postpartum glucose intolerance in women with GDM. Further studies are warranted to explore the underlying mechanism. Trial registration The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Sun Yat-sen University (reference number: [2014]No. 93). All participants provided written informed consent forms, and the ethics committee approved this consent procedure.

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The relationship between total cholesterol and postpartum impaired glucose tolerance in women with gestational diabetes mellitus

Cited by 6 publications

References 36 publications

Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia

Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia

Low Serum Creatinine Levels in Early Pregnancy Are Associated with a Higher Incidence of Postpartum Abnormal Glucose Metabolism among Women with Gestational Diabetes Mellitus: A Retrospective Cohort Study

Association between lipid trajectories during pregnancy and risk of postpartum glucose intolerance after gestational diabetes mellitus: a cohort study

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