The Predictive Ability of Two Triglyceride-Associated Indices for Gestational Diabetes Mellitus and Large for Gestational Age Infant Among Chinese Pregnancies: A Preliminary Cohort Study

Abstract

Peng Ju Liu,1 Yanping Liu,1 Liangkun Ma,2 Ai Min Yao,3 Xiao Yan Chen,4 Yi Xuan Hou,5 Li Ping Wu,5 Liang Yu Xia6 1Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Gynaecology and Obstetrics, Shunyi District Maternal and Child Health Hospital, Beijing, People’s Republic of China; 4Department of Gynaecology and Obstetrics, Quanzhou Maternal and Child Health Hospital, Fujian, People’s Republic of China; 5Peking Union Medical College School of Nursing, Beijing, People’s Republic of China; 6Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Yanping Liu Tel [phone]Fax [phone]Email [email protected]/Aims: To investigate the potential of maternal first-trimester triglyceride (TG) to high-density lipoprotein cholesterol (TG/HDL-c) ratio, triglyceride glucose index (TyG) and total cholesterol (TC)/HDL-c to predict the risk of later gestational diabetes mellitus (GDM) and large for gestational age (LGA) newborn in Chinese women.Methods: We included 352 women with a singleton pregnancy, who were followed up prospectively from the first prenatal visit until delivery. Fasting glucose and plasma lipid profiles including TG, TC, HDL-c, and low-density lipoprotein cholesterol (LDL-c) were measured in the first trimester. A binary logistic regression analysis was performed to determine the odds ratios (ORs) and 95% confidence intervals (CIs) of GDM and LGA according to tertiles of those indices, respectively. Receiver-operating characteristic curve (ROC) and areas under the curve (AUC) were employed to evaluate the ability of those indices to predict the risk of GDM and LGA infants, and differences in the AUC values between them were compared.Results: Women with the top tertile of TG/HDL-c or TyG other than TC/HDL-c had a significantly higher risk of GDM (ORTG/HDL-c=2.388, 95% CI 1.026– 5.467; ORTyG=3.535, 95% CI 1.483– 8.426, respectively) and LGA infant delivery (ORTG/HDL-c=3.742, 95% CI 1.114– 12.569; ORTyG=3.011, 95% CI 1.012– 8.962, respectively) than women with the lowest tertile of TG/HDL-c or TyG after adjusting for confounders. The AUC of TG/HDL-c and TyG to detect GDM was 0.664 (95% CI 0.595– 0.733) and 0.686 (95% CI 0.615– 0.756), respectively, and that to detect LGA was 0.646 (95% CI 0.559– 0.734) and 0.643 (95% CI 0.552– 0.735), respectively (all P < 0.01). There were no statistical differences between TG/HDL-c and TyG in the ability of predicting the risk of GDM or LGA infants.Conclusion: Maternal first-trimester TG/HDL-c and TyG are both good indicators in predicting the risk of later GDM and LGA newborn, and it may be useful to evaluate them in early pregnancy.Keywords: gestational diabetes, triglyceride/HDL-c ratio, triglyceride glucose index, large for gestational age infant

Keywords

• gestational diabetes
• triglyceride/hdl-c ratio
• triglyceride glucose index
• large-for-gestational-age infant