Maternal Hypertriglyceridemia in Gestational Diabetes: A New Risk Factor?

Overview

Journal Nutrients

Date 2024 Jun 19

PMID 38892511

Authors

Francisca Marques Puga

Diana Borges Duarte

Vania Benido Silva

Maria Teresa Pereira

Susana Garrido

Joana Vilaverde

Marta Sales Moreira

Fernando Pichel

Clara Pinto

Jorge Dores

Affiliations

Soon will be listed here.

Abstract

Elevated maternal triglycerides (TGs) have been associated with excessive fetal growth. However, the role of maternal lipid profile is less studied in gestational diabetes mellitus (GDM). We aimed to study the association between maternal lipid profile in the third trimester and the risk for large-for-gestational-age (LGA) newborns in women with GDM. We performed an observational and retrospective study of pregnant women with GDM who underwent a lipid profile measurement during the third trimester. We applied a logistic regression model to assess predictors of LGA. A total of 100 singleton pregnant women with GDM and third-trimester lipid profile evaluation were included. In the multivariate analysis, pre-pregnancy BMI (OR 1.19 (95% CI 1.03-1.38), = 0.022) and hypertriglyceridemia (OR 7.60 (1.70-34.10), = 0.008) were independently associated with LGA. Third-trimester hypertriglyceridemia was found to be a predictor of LGA among women with GDM, independently of glycemic control, BMI, and pregnancy weight gain. Further investigation is needed to confirm the role of TGs in excessive fetal growth in GDM pregnancies.

References

Metzger B, Lowe L, Dyer A, Trimble E, Chaovarindr U, Coustan D . Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358(19):1991-2002. DOI: 10.1056/NEJMoa0707943. View

Shafrir E, KHASSIS S . Maternal-fetal fat transport versus new fat synthesis in the pregnant diabetic rat. Diabetologia. 1982; 22(2):111-7. DOI: 10.1007/BF00254839. View

Xue R, Wu D, Zhou C, Chen L, Li J, Li Z . Association of high maternal triglyceride levels early and late in pregnancy with adverse outcomes: A retrospective cohort study. J Clin Lipidol. 2020; 15(1):162-172. DOI: 10.1016/j.jacl.2020.10.001. View

McAdams M, van Dam R, Hu F . Comparison of self-reported and measured BMI as correlates of disease markers in US adults. Obesity (Silver Spring). 2007; 15(1):188-96. DOI: 10.1038/oby.2007.504. View

Barrett H, Nitert M, dEmden M, Lingwood B, de Jersey S, McIntyre H . Capillary Triglycerides in Late Pregnancy-Challenging to Measure, Hard to Interpret: A Cohort Study of Practicality. Nutrients. 2021; 13(4). PMC: 8070156. DOI: 10.3390/nu13041266. View

Adank M, Benschop L, Kors A, Peterbroers K, Smak Gregoor A, Mulder M . Maternal lipid profile in early pregnancy is associated with foetal growth and the risk of a child born large-for-gestational age: a population-based prospective cohort study : Maternal lipid profile in early pregnancy and foetal growth. BMC Med. 2020; 18(1):276. PMC: 7532083. DOI: 10.1186/s12916-020-01730-7. View

Jin W, Lin S, Hou R, Chen X, Han T, Jin Y . Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China. BMC Pregnancy Childbirth. 2016; 16:60. PMC: 4802610. DOI: 10.1186/s12884-016-0852-9. View

Whyte K, Kelly H, ODwyer V, Gibbs M, OHiggins A, Turner M . Offspring birth weight and maternal fasting lipids in women screened for gestational diabetes mellitus (GDM). Eur J Obstet Gynecol Reprod Biol. 2013; 170(1):67-70. DOI: 10.1016/j.ejogrb.2013.04.015. View

Ehrenberg H, Durnwald C, Catalano P, Mercer B . The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol. 2004; 191(3):969-74. DOI: 10.1016/j.ajog.2004.06.057. View

10.

Yogev Y, H A Visser G . Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2008; 14(2):77-84. DOI: 10.1016/j.siny.2008.09.002. View

11.

Vrijkotte T, Krukziener N, Hutten B, Vollebregt K, van Eijsden M, Twickler M . Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study. J Clin Endocrinol Metab. 2012; 97(11):3917-25. DOI: 10.1210/jc.2012-1295. View

12.

Herrera E, Ortega-Senovilla H . Disturbances in lipid metabolism in diabetic pregnancy - Are these the cause of the problem?. Best Pract Res Clin Endocrinol Metab. 2010; 24(4):515-25. DOI: 10.1016/j.beem.2010.05.006. View

13.

Barrett H, Gatford K, Houda C, De Blasio M, McIntyre H, Callaway L . Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the metformin in gestational diabetes (MiG) trial: responses to maternal metformin versus insulin treatment. Diabetes Care. 2012; 36(3):529-36. PMC: 3579335. DOI: 10.2337/dc12-1097. View

14.

Wein P, Nolan C, Beischer N . Why do Asian-born women have a higher incidence of gestational diabetes? An analysis of racial differences in body habitus, lipid metabolism and the serum insulin response to an oral glucose load. Aust N Z J Obstet Gynaecol. 1993; 33(2):114-8. DOI: 10.1111/j.1479-828x.1993.tb02371.x. View

15.

Sousa-Santos R, Miguelote R, Cruz-Correia R, Santos C, Bernardes J . Development of a birthweight standard and comparison with currently used standards. What is a 10th centile?. Eur J Obstet Gynecol Reprod Biol. 2016; 206:184-193. DOI: 10.1016/j.ejogrb.2016.09.028. View

16.

Herrera Martinez A, Palomares Ortega R, Bahamondes Opazo R, Moreno-Moreno P, Molina Puerta M, Galvez-Moreno M . Hyperlipidemia during gestational diabetes and its relation with maternal and offspring complications. Nutr Hosp. 2018; 35(3):698-706. DOI: 10.20960/nh.1539. View

17.

Son G, Kwon J, Kim Y, Park Y . Maternal serum triglycerides as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand. 2010; 89(5):700-4. DOI: 10.3109/00016341003605677. View

18.

HOLLINGSWORTH D, Grundy S . Pregnancy-associated hypertriglyceridemia in normal and diabetic women. Differences in insulin-dependent, non-insulin-dependent, and gestational diabetes. Diabetes. 1982; 31(12):1092-7. DOI: 10.2337/diacare.31.12.1092. View

19.

Dathan-Stumpf A, Vogel M, Jank A, Thiery J, Kiess W, Stepan H . Reference intervals of serum lipids in the second and third trimesters of pregnancy in a Caucasian cohort: the LIFE Child study. Arch Gynecol Obstet. 2019; 300(6):1531-1539. DOI: 10.1007/s00404-019-05342-2. View

20.

Dong Y, Luo Z, Nuyt A, Audibert F, Wei S, Abenhaim H . Large-for-Gestational-Age May Be Associated With Lower Fetal Insulin Sensitivity and β-Cell Function Linked to Leptin. J Clin Endocrinol Metab. 2018; 103(10):3837-3844. PMC: 6179169. DOI: 10.1210/jc.2018-00917. View