Association Between Lipid Trajectories During Pregnancy and Risk of Postpartum Glucose Intolerance After Gestational Diabetes Mellitus: A Cohort Study

2021 ◽  
Author(s):  
Zhuofan Yang ◽  
Zhuyu Li ◽  
Yunjiu Cheng ◽  
Peisong Chen ◽  
Dongyu Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Insulin Sensitivity ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Early Postpartum ◽  
Significant Difference

Abstract Background: To assess lipid trajectories throughout pregnancy in relation to early postpartum glucose intolerance in women with gestational diabetes mellitus(GDM).Methods: This prospective cohort study included 221 Chinese women with GDM who completed plasma lipid test in each trimester of pregnancy and oral glucose tolerance test at 6-9 weeks post-delivery between January 1st 2018 and January 8th 2020. Using the group-based trajectory modeling (GBTM), total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), and high density lipoprotein-cholesterol(HDL-C) were identified separately as three trajectories: low, moderate, and high trajectory. The associations between lipid trajectories and early postpartum glucose intolerance were all evaluated.Results: Seventy-three participants developed postpartum glucose intolerance. For patients in low, moderate and high trajectory, the incidence of postpartum glucose intolerance was 38.4, 34.9, and 17.9%, respectively. GDM women with lower LDL-C trajectories presented a higher risk of postpartum glucose intolerance. The adjusted odds ratio(95% CI) for glucose intolerance was 3.14(1.17-8.39) in low LDL-C trajectory and 2.68(1.05-6.85) in moderate trajectory when compared with the high one. However, TC trajectory was not associated with risk of postpartum glucose intolerance, nor were TG trajectory and HDL-C trajectory. Moreover, a significant difference of insulin sensitivity was observed in participants with different LDL-C trajectories, participants in high LDL-C trajectory had the highest insulin sensitivity whereas the women in low LDL-C trajectory had the lowest insulin sensitivity(P=0.02). Conclusions: The high trajectory of LDL-C during pregnancy may play a protective role on postpartum glucose intolerance in women with GDM. Further studies are warranted to explore the underlying mechanism.Trial registration: The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Sun Yat-sen University(reference number: [2014]No. 93). All participants provided written informed consent forms, and the ethics committee approved this consent procedure.

scholarly journals The effect of breastfeeding on postpartum glucose tolerance and lipid profiles in women with gestational diabetes mellitus

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Alexis Shub ◽  
Manisha Miranda ◽  
Harry M. Georgiou ◽  
Elizabeth A. McCarthy ◽  
Martha Lappas
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Exclusive Breastfeeding ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Lipid Profiles ◽  
Lipoprotein Cholesterol ◽  
Maternal Body Mass Index ◽  
Glucose Levels

Abstract Background We aimed to investigate the association of breastfeeding on postpartum glucose levels and lipid profiles in women diagnosed with gestational diabetes mellitus (GDM) and women without GDM. Methods We performed a secondary analysis of a cohort study of 243 women, 159 women with GDM and 84 normally glucose tolerant women between 2012 and 2017. At approximately 6–10 weeks postpartum, we measured fasting blood glucose and plasma lipid levels. Breastfeeding behaviour was self-defined as exclusive breastfeeding or not exclusive breastfeeding. Results The mean (SD) glucose in the group of women who breastfed exclusively was 4.6 (0.49) mmol/L, compared to 4.9 (0.58) mmol/L (95% CI 0.45, 0.15, p <  0.001) among women who did not exclusively breastfeed. Among women with GDM, the reduction in fasting glucose in women who were breastfeeding was 0.22 mmol/L (95% CI 0.39, 0.05, p = 0.004), and in women who were not GDM, the reduction was 0.14 mmol/L (95% CI 0.37, 0.09, p = 0.24,). After adjustment for GDM status in pregnancy, maternal body mass index (BMI), maternal age and ethnicity, and exclusive breastfeeding was associated with a decreased fasting glucose of 0.19 (95% CI 0.318, 0.061, p = 0.004). After similar adjustment, there was no significant difference in triglycerides, high density lipoprotein cholesterol or low-density lipoprotein cholesterol between women who were breastfeeding and women who were not breastfeeding. Conclusions Breastfeeding is associated with a reduction in fasting glucose levels postpartum, but not maternal lipid profile. Breastfeeding may play a role in reducing glucose intolerance in women who have had GDM.

Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum

2003 ◽  
Vol 61 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Hak C. Jang ◽  
Chang-Hoon Yim ◽  
Ki O. Han ◽  
Hyun-Koo Yoon ◽  
In-Kwon Han ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Early Postpartum

scholarly journals Early Post-partum Glucose Intolerance, Metabolic Syndrome and Gestational Diabetes Mellitus Determinants After Assisted Conception: A Prospective Cohort Study

2020 ◽  
Author(s):  
Azam Kouhkan ◽  
Roya Hosseini ◽  
Hamid Reza Baradaran ◽  
Arezoo Arabipoor ◽  
Rezvaneh Cheraghi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Post Partum ◽  
Assisted Conception

Abstract Background: This study aimed to determine the prevalence of postpartum metabolic syndrome (MetS), glucose intolerance and other determinants, 6-12 weeks postpartum in women with assisted reproduction technology conception gestational diabetes mellitus diagnosis (ART-GDM) compared to women with spontaneous conception and GDM diagnosis (SC-GDM).Methods: In this prospective cohort study, two groups consisted of 62 ART-GDM and 64 SC-GDM singleton pregnant women were followed 6-12 weeks after delivery for postpartum MetS. Fasting glucose, 75-g 2-h OGTT and lipid profile were assessed. Waist and hip circumference, and systolic and diastolic blood pressures (BP) were measured at post- partum. Clinical, para clinical and obstetric data were recorded from registry offices. The prevalence of MetS and glucose intolerance were determined. Predictors of Mets and glucose intolerance were determined by logistic regression. Results: The prevalence of postpartum MetS was 20.8% in ART-GDM women and 10.9% in SC-GDM, P=0.123). Mean postpartum BMI and systolic BP were significantly higher in the ART-GDM group (P=0.016 and P=0.027, respectively). Adverse pregnancy outcomes were significantly higher in the ART-GDM group. Postpartum glucose intolerance prevalence did not vary significantly between the groups. Family history of diabetes was a predictive factor for postpartum MetS and glucose intolerance 6-12 weeks after delivery.Conclusions: Early postpartum MetS and glucose intolerance prevalence after assisted conception did not vary significantly; however, postpartum BMI and systolic BP were significantly higher in the ART-GDM group. Lifestyle modification program and long-term health care of ART women with GDM diagnosis can be recommended. Further studies with larger sample size and longer follow-up are necessary to verify our findings.

scholarly journals Effect of alpha-lipoic acid supplementation on the lipid profile and lipid ratios in women with gestational diabetes mellitus: A clinical trial study

2020 ◽  
Author(s):  
Hadise Aslfalah ◽  
Mehri Jamilian ◽  
Hadi Ansarihadipour ◽  
Mahdi Abdollahi ◽  
Ali Khosrowbeygi
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lipid Profile ◽  
Lipoic Acid ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Alpha Lipoic Acid ◽  
Tyg Index ◽  
Lipid Ratios

Background: Evidence suggests that Oxidative stress has been shown to plays an important role in gestational diabetes mellitus (GDM) etiology. On the other hand, women with GDM are at an increased risk for complications such as endothelial dysfunction and cardiovascular diseases. Objective: To investigate the effects of alpha-lipoic acid (ALA) on the maternal circulating values of lipid profile and lipid ratios in women with GDM. Materials and Methods: Sixty women with GDM were participated in the present study. The ALA group (n = 30) received ALA (100 mg/day) and the placebo group (n = 30) received cellulose acetate (100 mg/day) for eight wk. The maternal circulating values of hemoglobin A1C, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL-C, and lipid ratios were assessed before and after the intervention. P-value < 0.05 was considered as statistically significant. Results: The values of TyG index (p < 0.001), TG (p = 0.006), TG/HDL-C (p = 0.003), and AIP (p = 0.005) decreased significantly in the ALA group after the intervention. Conclusion: Maternal circulating values of TyG index, TG, TG/HDL, AIP decreased after eight wk of ALA supplementation in women with GDM. Key words: Lipoic acid, Gestational diabetes, Lipids, Triglycerides, Cholesterol.

scholarly journals The Predictive Effects of Early Pregnancy Lipid Profiles and Fasting Glucose on the Risk of Gestational Diabetes Mellitus Stratified by Body Mass Index

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Chen Wang ◽  
Weiwei Zhu ◽  
Yumei Wei ◽  
Rina Su ◽  
Hui Feng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
High Density Lipoprotein ◽  
Early Pregnancy ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Lipid Profiles ◽  
Lipoprotein Cholesterol

This study aimed at evaluating the predictive effects of early pregnancy lipid profiles and fasting glucose on the risk of gestational diabetes mellitus (GDM) in patients stratified by prepregnancy body mass index (p-BMI) and to determine the optimal cut-off values of each indicator for different p-BMI ranges. A retrospective system cluster sampling survey was conducted in Beijing during 2013 and a total of 5,265 singleton pregnancies without prepregnancy diabetes were included. The information for each participant was collected individually using questionnaires and medical records. Logistic regression analysis and receiver operator characteristics analysis were used in the analysis. Outcomes showed that potential markers for the prediction of GDM include early pregnancy lipid profiles (cholesterol, triacylglycerols, low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratios [LDL-C/HDL-C], and triglyceride to high-density lipoprotein cholesterol ratios [TG/HDL-C]) and fasting glucose, of which fasting glucose level was the most accurate indicator. Furthermore, the predictive effects and cut-off values for these factors varied according to p-BMI. Thus, p-BMI should be a consideration for the risk assessment of pregnant patients for GDM development.

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