Correlation analysis of plasma lipid with glucose status and insulin resistance in pregnant women with gestational diabetes mellitus
10.3969/j.issn.1674-8115.2019.07.014
- Author:
Hua-Ying YE
1
Author Information
1. Department of Obstetrics and Gynecology, the Third Affiliated Hospital, Soochow University
- Publication Type:Journal Article
- Keywords:
Gestational diabetes mellitus;
Insulin resistance;
Lipid metabolism;
Macrosomia
- From:
Journal of Shanghai Jiaotong University(Medical Science)
2019;39(7):768-773
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the correlation of plasma lipid with gestational diabetes mellitus (GDM) and insulin resistance in women with GDM, and to analyze the effect of plasma lipid on pregnancy outcome. Methods: A total of 922 pregnant women with GDM who underwent prenatal examination in Shanghai Sixth People's Hospital from January 2012 to April 2017 were selected for plasma lipid examination in the second trimester of pregnancy [(14.7±2.8) weeks]. Oral 75 g glucose tolerance test (OGTT) and islet function examination were performed during 24-28 weeks of pregnancy. According to the fasting triacylglycerol (TAG) level in the second trimester of pregnancy, they were divided into three groups: group T1 (TAG ≤ 1.3 mmol/L, n=310), group T2 (1.31.79 mmol/L could be used as an index to predict glucose status in GDM patients (P=0.001). ②Compared with group T1 and T2, group T3 showed significantly increased fasting glucose, fasting insulin, HOMA-IR, MBCI, and decreased WBSIS (all P<0.05). Multivariate linear regression analysis showed that BMI before pregnancy and TAG in the second trimester were independently correlated with HOMA-IR (β=0.213, β=0.224, both P=0.000). BMI before pregnancy was independently correlated with MBCI (β=0.811, P=0.000). ③The incidences of macrosomia and caesarean in group T3 were significantly higher than those in group T1 (both P<0.05). After adjusting for age and pre-pregnancy BMI, TAG in the second trimester did not increase the risk of macrosomia. TAG>4.19 mmol/L in the third trimester and TAG level in the second trimester to the third one increasing by 2.38 mmol/L or more, were high risk factors for macrosomia (both P=0.001). Conclusion: Increased TAG (TAG>1.79 mmol/L) in the second trimester is an independent and correlated factor of insulin resistance, which may aggravate GDM. Increased TAG levels (TAG increasing>2.38 mmol/L) from the second trimester to the third one and high TAG (TAG>4.19 mmol/L) in the third trimester are risk factors for macrosomia.
