Elevated maternal lipids associated with development of gestational diabetes
Elevated maternal lipids, especially elevated levels of triglycerides, were associated with the development of gestational diabetes, according to new results from a systematic review and meta-analysis.
“Although the cause of gestational diabetes is not fully understood, maternal obesity, older maternal age and women from certain ethnic groups have been identified as being at high risk. Increasingly, attention has been given to the associations between impaired glucose metabolism, abnormal circulating lipid levels and consequent worsening of glucose intolerance,” Jiamiao Hu, MD, from the College of Food Science at Fujian Agriculture and Forestry University, China, and the department of cardiovascular sciences at the University of Leicester and Diabetes Research Centre at Leicester General Hospital, U.K., and colleagues wrote in EClinicalMedicine. “While the exact relationship between maternal plasma lipid metabolism and maternal glucose remain unclear, recent studies have highlighted that gestational diabetes induces a state of dyslipidemia consistent with insulin resistance.”
The systematic review and meta-analysis included 292 studies that reported on circulating lipid profiles during pregnancy in those with and without gestational diabetes until February 2021. These studies included 97,880 pregnant women, of whom 28,232 had gestational diabetes and 69,648 served as controls.
Researchers retained studies describing original data with at least one raw lipid, including triglycerides, total cholesterol, HDL, LDL or VLDL measurements.
There was a higher percentage of triglyceride levels among women with gestational diabetes by 20%, with a pooled weighted mean difference (WMD) of 0.388 mM (95% CI, 0.336-0.439; P < .001) between pregnant women with gestational diabetes and controls. Women with gestational diabetes also had higher total cholesterol (WMD, 0.149 mM; 95% CI, 0.082-0.214; P < .001), LDL (WMD, 0.079 mM; 95% CI, 0.018-0.14; P = .011) and VLDL (WMD, 0.216 mM; 95% CI, 0.1-0.332; P < .001) as well as lower HDL (WMD, –0.079 mM; 95% CI, –0.1 to –0.058; P < .001) compared with controls.
Researchers also observed the elevated triglyceride levels occurred in the first trimester and persisted onward.
The differences between those with and without gestational diabetes in triglyceride levels were significantly associated with age, BMI, study continent, oral glucose tolerance test procedure and gestational diabetes diagnosis criteria in meta-regression analyses.
According to the researchers, high heterogeneity observed in this study suggested that triglyceride levels may be influenced by variables, including ethnicity and BMI, which have previously been identified as gestational diabetes risk factors.
“The findings from this study also suggest that elevated lipid levels, particularly triglycerides, is associated with future risk of gestational diabetes and could potentially be integrated into a risk stratification algorithm to calculate the risk of gestational diabetes,” the researchers wrote.