Elevated Midtrimester Triglycerides as a Biomarker for Postpartum Hyperglycemia in Gestational Diabetes
Elevated Midtrimester Triglycerides as a Biomarker for Postpartum Hyperglycemia in Gestational Diabetes
复制标题
妊娠中期甘油三酯升高作为妊娠糖尿病产后高血糖的生物标志物
DOI：
10.1155/2020/3950652
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发表时间：
2020-04-24
影响因子：
4.3
通讯作者：
Peng, Yongde
中科院分区：
文献类型：
--
作者：
Lai, Mengyu;Fang, Fang;Peng, Yongde
妊娠期甘油三酯（TG）水平升高是否是既往妊娠期糖尿病（GDM）妇女产后糖代谢异常（AGM）的生物标志物仍不清楚。本研究旨在探讨妊娠期糖尿病妇女妊娠中期TG水平与产后AGM的关系。方法对513例GDM妇女进行回顾性队列研究。进行75 g口服葡萄糖耐量试验（OGTT），并在妊娠期和产后期间测定血脂水平。根据妊娠24-28周TG水平将GDM患者分为三组（TG < 2.14 mmol/L，TG：2.14-2.89 mmol/L，TG > 2.89 mmol/L）。使用逻辑回归模型计算比值比（OR）和95%置信区间（CI）。结果妊娠期高TG组孕妇HbA 1c水平明显高于对照组（5.47 ± 0.58% vs 5.28 ± 0.49%，p = 0.006），总胆固醇（TC）水平较高（5.85 ± 1.23 mmol/L vs 5.15 ± 0.97 mmol/L，p = 0.026），HOMA-IR（2.36（1.62-3.45）vs 1.49（0.97-2.33），p < 0.001）高于低TG三分位数的参与者。分娩后，基于妊娠期TG水平以上三分位数的AGM患病率分别为26.90%、33.33%和43.27%（p = 0.006）。妊娠中期高TG三分位数与产后AGM的存在相关（校正OR：2.001，95%CI：1.054-3.800，p = 0.034）。结论妊娠中期TG水平的升高不仅伴随着血糖、血脂水平的升高和胰岛素抵抗的加重，而且是产后AGM的生物标志物。
Background Whether elevated triglyceride (TG) levels during pregnancy were a biomarker for postpartum abnormal glucose metabolism (AGM) in women with previous gestational diabetes mellitus (GDM) remained unknown. The aim of this study was to investigate the association between TG levels during the second trimester and postpartum AGM in GDM women. Methods This was a retrospective cohort study including 513 GDM women. A 75 g oral glucose tolerance test (OGTT) was performed, and lipid levels were determined during pregnancy and the postpartum period. GDM patients were categorized into tertiles according to their TG levels at 24–28 weeks of gestation (TG < 2.14 mmol/L, TG: 2.14–2.89 mmol/L, and TG > 2.89 mmol/L). A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Results During pregnancy, women in the high TG tertile showed higher HbA1c levels (5.47 ± 0.58% versus 5.28 ± 0.49%, p = 0.006), higher total cholesterol (TC) levels (5.85 ± 1.23 mmol/L versus 5.15 ± 0.97 mmol/L, p = 0.026), and higher HOMA-IR (2.36 (1.62-3.45) versus 1.49 (0.97-2.33), p < 0.001) than the participants in the low TG tertile. After delivery, the prevalence rates of AGM based on above tertiles of TG levels during pregnancy were 26.90%, 33.33%, and 43.27%, respectively (p = 0.006). High TG tertile during the second trimester was associated with the presence of postpartum AGM (adjusted OR: 2.001, 95% CI: 1.054-3.800, p = 0.034). Conclusions The elevated midtrimester TG levels were not only accompanied by higher glucose and lipid levels and more severe insulin resistance at the time of the measurement but were a biomarker for postpartum AGM as well.