High serum triglyceride levels in the early first trimester of pregnancy are associated with gestational diabetes mellitus: A prospective cohort study

• Published in: Journal of diabetes investigation Vol. 11; no. 6; pp. 1635 - 1642
• Main Authors: Zhu, Haiyan, He, Dian, Liang, Ning, Lai, Ailuan, Zeng, Jingbo, Yu, Huanling
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.11.2020; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Biomarkers - blood; Body Mass Index; Case-Control Studies; China - epidemiology; Cohort analysis; Diabetes mellitus; Diabetes, Gestational - blood; Diabetes, Gestational - epidemiology; Diabetes, Gestational - etiology; Diabetes, Gestational - pathology; Female; Follow-Up Studies; Gestational age; Gestational diabetes; Gestational diabetes mellitus; Glucose; Humans; Hypertension; Hypertriglyceridemia - complications; Lipids; Menstruation; Metabolism; Original; Overweight; Pregnancy; Pregnancy Trimester, First; Prognosis; Prospective Studies; Questionnaires; Regression analysis; Risk Factors; Triglyceride; Triglycerides - blood; Variance analysis; China; Pregnancy; Gestational diabetes mellitus; Triglyceride
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13273

Aims/Introduction Pregnant women with gestational diabetes mellitus (GDM) have been reported to have higher serum triglyceride (TG) levels during the entire gestational period. However, whether TGs contribute to the incidence of GDM remains unclear. This study aimed to evaluate whether higher serum TG level during early first trimester is associated with GDM. Materials and Methods A prospective single‐center cohort study was carried out among pregnant women (n = 2,949) who received regular antenatal care in Fu Xing Hospital, Capital Medical University, Beijing, China. GDM was diagnosed between 24 and 28 gestational weeks. Serum TG levels were measured during gestational weeks 6–8 (TG0) and 16–18 (TG1). TG elevation was the difference between TG1 and TG0. Results In total, 581 pregnant women developed GDM. A 13.1, 18.5 and 28.8% incidence of GDM was observed in women with low, referent and high TG0 levels, respectively. Among women with prepregnancy body mass index <24 kg/m2 and prepregnancy body mass index ≥24 kg/m2, those with high TG0 levels had 2.4‐ and 2.3‐fold increased odds of developing GDM, respectively, compared with pregnant women with low TG0 levels. A positive dose–response relationship was observed between continuous TG0 and TG elevation, and the odds of GDM; a positive association was observed between TG elevation and the odds of developing GDM in pregnant women with intermediate to high TG0 levels. Conclusion High TG level during the early first trimester, and TG elevation from the first to early second trimester are associated with GDM development, which persists even after adjusting for confounders. This is the first study to evaluate the elevations in triglyceride from the early first trimester (weeks 6–8) to the early second trimester (weeks 16–18) in such a large sample. We observed the association between triglyceride and the odds of developing gestational diabetes mellitus, and confirmed this association in all the stratified prepregnancy body mass index groups. Based on our results, we recommend specialized management of pregnant women with high triglyceride levels during 6–8 weeks of gestation, which could help prevent high‐risk patients from developing gestational diabetes mellitus.