Association of maternal lipid profile and gestational diabetes mellitus: A systematic review and meta-analysis of 292 studies and 97,880 women.
Association of maternal lipid profile and gestational diabetes mellitus: A systematic review and meta-analysis of 292 studies and 97,880 women.
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母亲血脂状况与妊娠糖尿病的关联：对 292 项研究和 97,880 名女性的系统回顾和荟萃分析。
DOI：
10.1016/j.eclinm.2021.100830
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发表时间：
2021-04
影响因子：
15.1
通讯作者：
Tan BK
中科院分区：
文献类型：
--
作者：
Hu J;Gillies CL;Lin S;Stewart ZA;Melford SE;Abrams KR;Baker PN;Khunti K;Tan BK
妊娠期糖尿病（GDM）是妊娠期最常见的代谢紊乱，然而，血脂异常与GDM之间的关系尚不清楚。我们检索了截至2021年2月的Medline、Scopus、Web of Science、科克伦、母婴护理数据库（MIDIRS）和ClinicalTrials.gov，以查找报告妊娠期、GDM女性和非GDM女性循环脂质特征的相关研究。保留描述原始数据的出版物，其中至少有一项原始脂质[甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）或极低密度脂蛋白胆固醇（VLDL-C）]测量。使用试点数据提取表进行数据提取。该方案已在PROSPERO注册（CRD 42019139696）。共纳入292项研究，包括97，880名孕妇（28，232名GDM和69，648名对照）。使用随机效应荟萃分析模型汇总研究估计值，GDM女性的TG水平显著较高（20%），GDM和非GDM妊娠之间的汇总加权平均差异为0.388 mM（0.336，0.439，p < 0.001）。进一步的分析显示，TG水平升高发生在妊娠的前三个月，之后持续存在。Meta回归分析显示，GDM妇女和健康对照组之间的TG水平差异与年龄、BMI、研究大陆、OGTT程序和GDM诊断标准显著相关。血脂升高，特别是TG，与GDM相关。
Gestational Diabetes Mellitus (GDM) is the most prevalent metabolic disorder during pregnancy, however, the association between dyslipidaemia and GDM remains unclear. We searched Medline, Scopus, Web of Science, Cochrane, Maternity and Infant Care database (MIDIRS) and ClinicalTrials.gov up to February 2021 for relevant studies which reported on the circulating lipid profile during pregnancy, in women with and without GDM. Publications describing original data with at least one raw lipid [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or very low-density lipoprotein cholesterol (VLDL-C)] measurement were retained. Data extraction was performed using a piloted data extraction form. The protocol was registered with PROSPERO (CRD42019139696). A total of 292 studies, comprising of 97,880 pregnant women (28232 GDM and 69,648 controls) were included. Using random-effects meta-analysis models to pool study estimates, women with GDM had significantly higher (by 20%) TG levels, with a pooled weighted mean difference between GDM and non-GDM pregnancies of 0.388 mM (0.336, 0.439, p < 0.001). Further analyses revealed elevated TG levels occur in the first trimester and persist afterwards. Meta-regression analyses showed that differences in TG levels between women with GDM and healthy controls were significantly associated with age, BMI, study continent, OGTT procedure, and GDM diagnosis criteria. Elevated lipids, particularly, TG, are associated with GDM.
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