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December 1, 2025Open Access

Association between triglyceride-to-HDL-cholesterol ratio and risk of gestational diabetes mellitus in the first trimester: a retrospective cohort study.

Key Points

Gestational diabetes mellitus risk is significantly influenced by first trimester triglyceride-to-HDL ratio elevation, leading to implications for early screening.
Logistic regression indicated an odds ratio of 1.37 for increased GDM risk per unit increase in triglyceride-to-HDL ratio among 2,356 women.
Nonlinear associations were noted, particularly in women over 35 years and with BMI greater than or equal to 25 kg/m², raising concerns for targeted interventions.
Findings emphasize the importance of risk stratification based on first trimester lipid profiles for better maternal health outcomes.

Abstract

This retrospective cohort study examined the association between first-trimester triglyceride-to-HDL cholesterol (TG/HDL-C) ratio and gestational diabetes mellitus (GDM) risk among 2,356 pregnant women from Shanghai General Hospital between October 2019, and June 2021. Using logistic regression and restricted cubic spline models, we found the TG/HDL-C ratio was an independent GDM predictor (OR:1.37, 95%CI:1.16-1.62, p35 years (OR:1.60, 95%CI:1.12-2.28) and those with BMI≥25kg/m² (OR:1.78, 95%CI:1.25-2.54). First-trimester TG/HDL-C ratio elevation significantly increases GDM risk, suggesting its potential for early risk stratification and targeted prevention.

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