Study of the correlation between serum lipid parameters during pregnancy and gestational diabetes mellitus and neonatal cord-blood C-peptide

Abstract

Objective To analyze the changes of serum lipid levels in pregnant women with gestational diabetes mellitus （GDM） and the relationship between serum lipid levels during pregnancy and GDM， neonatal birth weight and cord-blood C-peptide. Methods In this case-control study， clinical data of 673 pregnant women were collected. According to the results of 75-g oral glucose tolerance test （OGTT） in the second trimester （Tr2）， 673 pregnant women were divided into the GDM group （n = 150） and normal glucose tolerance （NGT） group （n = 523）. The risk factors of GDM were identified by Logistic regression analysis. The correlation between serum lipid level， neonatal weight and cord-blood C-peptide in GDM pregnant women was analyzed by Spearman correlation. Results During the first trimester （Tr1）， triglyceride （TG） level was higher and lipoprotein（a） [Lp（a）] level was lower in the GDM group than those in the NGT group. During Tr2， TC and high-density lipoprotein cholesterol （HDL-C） levels in the GDM group were lower compared with those in the NGT group. In the third trimester （Tr3）， TG level and apolipoprotein A1/B （ApoA1/B） ratio were higher and ApoB level was lower in the GDM group than those in the NGT group， with statistical significance （all P < 0.05）. Age （OR = 1.111， 95%CI = 1.065-1.158， P < 0.001） and Lp（a） in Tr1 （OR = 0.660， 95%CI = 0.454-0.960， P = 0.030） were the independent factors of the incidence of GDM. Neonatal birth weight was negatively correlated with age （rs = -0.253， P = 0.013）， whereas positively correlated with postpartal body mass index （BMI） （rs = 0.241， P = 0.017）， gestational weight gain （GWG） （rs =0.270， P = 0.017） and gestational age at delivery （rs = 0.34， P = 0.001）. In Tr1 and Tr3， neonatal birth weight was positively correlated with TG and ApoB levels， whereas negatively correlated with ApoA1/B ratio. Neonatal birth weight was positively correlated with ApoE level in Tr3 （rs = 0.227， P = 0.025）. Neonatal cord-blood C-peptide level was negatively correlated with ApoE levels in Tr2 （rs = -0.218， P = 0.038） and Tr3 （rs = -0.227， P = 0.031）. Conclusions Pregnant women with GDM develop lipid metabolism disorder in Tr1. During pregnancy， monitoring the changes in blood lipids and maintaining normal blood lipid levels can effectively control the complications during pregnancy and mitigate the effect of adverse pregnancy outcomes on mother and neonate.

Keywords

• |gestational diabetes mellitus|pregnant woman|glucose|lipid|neonate