Key result
Higher second-trimester atherogenic index of plasma linked to ~18-fold greater gestational diabetes risk per unit.
Why the study?
Research on dyslipidemia during pregnancy in women with gestational diabetes mellitus has rarely been conducted in Asia.
Cohort (n=632)
No
Effect estimate: OR 18.48 (95% CI 2.38-143.22)
p-value: p=0.005
Elevated mid-trimester atherogenic index of plasma (AIP) is strongly associated with an increased risk of gestational diabetes mellitus.
Mid-trimester AIP elevation signals higher GDM risk; leaves open whether AIP monitoring improves pregnancy outcomes.
BACKGROUND: Research on dyslipidemia during pregnancy in women with gestational diabetes mellitus (GDM) has rarely been conducted in Asia. The present study aimed to evaluate maternal mid-trimester lipid profile in relation to GDM and clinical outcomes in these high-risk populations. METHODS: The medical records of 632 pregnant women in the second trimester were retrospectively analyzed. Maternal fasting serum lipids were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein A1 (Apo A1) and Apo B concentrations during the second trimester. The atherogenic index of plasma (AIP) was calculated as log (TG/HDL). The clinical outcomes were collected by evaluating delivery mode, postpartum hemorrhage, prematurity, macrosomia, birth weight, body length and neonatal Apgar 5 min score. RESULTS: Levels of TG and AIP were elevated while decreased HDL-C was observed in women with GDM compared with that of the control group. Significant differences were observed in gestational weeks at birth, cesarean section, postpartum hemorrhage, birth weight, body length, prematurity and macrosomia between the two groups. Compared with women with hyperlipidemia, the incidence of GDM and cesarean section was lower in normal lipid group. Women in the hyperlipidemia group had smaller gestational weeks at birth than those in the control group. According to the logistic regression analysis, each unit elevation in AIP increased the risk of GDM by 18.48 times (OR = 18.48, CI: 2.38-143.22). Besides, age (OR = 1.11, CI: 1.06-1.16) and pre-pregnancy BMI (OR = 1.15, CI: 1.07-1.24) were the risk factors of GDM. CONCLUSIONS: These findings suggested that reasonable lipid control in the second trimester might reduce the incidence of GDM and be a potential strategy for improving clinical outcomes in these high-risk women.
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Li et al. (2021) conducted a cohort in Gestational diabetes mellitus (n=632). Atherogenic index of plasma (AIP) elevation was evaluated on Incidence of gestational diabetes mellitus (OR 18.48, 95% CI 2.38-143.22, p=0.005). Each unit elevation in the atherogenic index of plasma during the second trimester increased the risk of gestational diabetes mellitus by 18.48 times (OR 18.48).
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