The Correlation Between Plasma Total Homocysteine Level and Gestational Diabetes Mellitus in a Chinese Han Population

To assess the correlation between plasma total homocysteine (tHcy) level and gestational diabetes mellitus (GDM) in a Chinese Han population. This case-control study included 350 GDM patients and 346 gestational week-matched normal glucose tolerance (NGT) pregnant women. Plasma tHcy and insulin levels were analyzed by HPLC and ELISA respectively. Logistic regression analysis was used to investigate the correlation between plasma tHcy level and risk of GDM. Women with GDM had a higher plasma tHcy level than NGT women (6.61 ± 1.32 vs. 6.17 ± 1.29 μmol/L, P = 0.001)). The GDM risk was 1.79 (OR = 1.79, 95% CI 1.18-2.72, P = 0.006) times higher in women whose plasma tHcy level was ≥ 7.29 μmol/L compared to women with plasma tHcy level < 5.75 μmol/L. Stratified analysis showed the GDM risk were much higher when HOMA-IR index ≥ 2 (OR = 5.42, 95% CI 2.51-11.74, P < 0.001), age ≥ 30 years (OR = 5.14, 95% CI 2.78-9.52, P < 0.001), or women with a family history of type 2 diabetes mellitus (T2DM) (OR = 4.13, 95% CI 1.78-9.56, P = 0.001). In the Chinese Han population, an elevated plasma tHcy level may increase the overall risk of GDM especially in women with a high HOMA-IR index, increasing age or with family history of T2DM.