| Citation: |
YANG Xuanjin, WANG Yaxin, LI Yini, ZHANG Suhan, MA Liangkun, SUN Yin. Association of Triglyceride to High Density Lipoprotein-Cholesterol Ratio In Early Pregnancy with the Risk of Gestational Diabetes Mellitus: Large-sample Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 580-586. DOI: 10.12290/xhyxzz.2023-0495
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To investigate the association of triglyceride to high density lipoprotein-cholesterol ratio (TG/HDL-C) in early pregnancy with the risk of gestational diabetes mellitus (GDM).
Retrospectively collected clinical data of singleton pregnant women who received regular antenatal care and delivered at Peking Union Medical College Hospital from July 2020 to June 2022. Based on the results of the 75 g oral glucose tolerance test (OGTT) from 24 to 28 weeks, pregnant women were classified into GDM group and normal glucose tolerance (NGT) group. Multiple Logistic regression was used to evaluate the correlation between TG /HDL-C in early pregnancy (8-12+6weeks) and GDM, and triglyceride-glucose (TyG) index was used as a reference to assess the value of TG/HDL-C in early pregnancy in predicting GDM.
A total of 1617 singleton pregnant women who met the inclusion and exclusion criteria were enrolled, with 372 (23.01%) in the GDM group and 1245 (76.99%) in the NGT group. After adjusting for confounding factors, such as maternal age, ethnicity, pre-pregnancy BMI, GDM history and family history of diabetes, pregnant women in the highest TG/HDL-C quartile had a 2.46-fold higher risk of developing GDM than those in the lowest TG/HDL-C quartile (OR=2.46, 95% CI: 1.73-3.51). Pregnant women in the highest TyG index quartile had a 2.36-fold higher risk of developing GDM than those in the lowest TyG index quartile (OR=2.36, 95% CI: 1.67-3.37). The efficacy of TG/HDL-C in early pregnancy in predicting GDM (area under the curve: 0.607 vs. 0.608) and the degree of improvement in the basic risk model of GDM (net reclassification improvement: 0.240 vs. 0.270; integrated discrimination improvement: 0.022 vs. 0.024) were both close to the TyG index.
Higher TG/HDL-C in early pregnancy was independently associated with higher risk of GDM. Its predictable value was comparable to that of TyG index.
| [1] |
Gao C H, Sun X, Lu L, et al. Prevalence of gestational diabetes mellitus in mainland China: a systematic review and meta-analysis[J]. J Diabetes Investig, 2019, 10(1): 154-162. DOI: 10.1111/jdi.12854
|
| [2] |
Johns E C, Denison F C, Norman J E, et al. Gestational diabetes mellitus: mechanisms, treatment, and complications[J]. Trends Endocrinol Metab, 2018, 29(11): 743-754. DOI: 10.1016/j.tem.2018.09.004
|
| [3] |
Sweeting A, Wong J, Murphy H R, et al. A clinical update on gestational diabetes mellitus[J]. Endocr Rev, 2022, 43(5): 763-793. DOI: 10.1210/endrev/bnac003
|
| [4] |
Ye W R, Luo C, Huang J, et al. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis[J]. BMJ, 2022, 377: e067946.
|
| [5] |
中华医学会妇产科学分会产科学组, 中华医学会围产医学分会, 中国妇幼保健协会妊娠合并糖尿病专业委员会. 妊娠期高血糖诊治指南(2022)[第一部分][J]. 中华妇产科杂志, 2022, 57(1): 3-12.
Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association, Chinese Society of Perinatal Medicine, Chinese Medical Association, Commitee of Pregnancy with Diabetes Mellitus, China Maternal and Child Health Association. Guideline of diagnosis and treatment of hyperglycemia in pregnancy (2022)[Part one][J]. Chin J Obstet Gynecol, 2022, 57(1): 3-12.
|
| [6] |
Kosmas C E, Rodriguez Polanco S, Bousvarou M D, et al. The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio as a risk marker for metabolic syndrome and cardiovascular disease[J]. Diagnostics (Basel), 2023, 13(5): 929. DOI: 10.3390/diagnostics13050929
|
| [7] |
De Farias Lelis D, Calzavara J V S, Santos R D, et al. Reference values for the triglyceride to high-density lipoprotein ratio and its association with cardiometabolic diseases in a mixed adult population: the ELSA-Brasil study[J]. J Clin Lipidol, 2021, 15(5): 699-711. DOI: 10.1016/j.jacl.2021.07.005
|
| [8] |
Nur Zati Iwani A K, Jalaludin M Y, Yahya A, et al. TG: HDL-C ratio as insulin resistance marker for metabolic syndrome in children with obesity[J]. Front Endocrinol (Lausanne), 2022, 13: 852290. DOI: 10.3389/fendo.2022.852290
|
| [9] |
Sharma A K, Singh S, Singh H, et al. Deep insight of the pathophysiology of gestational diabetes mellitus[J]. Cells, 2022, 11(17): 2672. DOI: 10.3390/cells11172672
|
| [10] |
赵雅萍, 凌莉. 孕中期血脂LDL/HDL及TG/HDL比值与妊娠期糖尿病的相关性研究[J]. 现代妇产科进展, 2020, 29(12): 921-924. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202012010.htm
Zhao Y P, Ling L. Study on the relationship between LDL/HDL and TG/HDL ratio in the second trimester of pregnancy and gestational diabetes[J]. Prog Obstet Gynecol, 2020, 29(12): 921-924. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202012010.htm
|
| [11] |
Wang D Y, Xu S Q, Chen H T, et al. The associations between triglyceride to high-density lipoprotein cholesterol ratios and the risks of gestational diabetes mellitus and large-for-gestational-age infant[J]. Clin Endocrinol (Oxf), 2015, 83(4): 490-497. DOI: 10.1111/cen.12742
|
| [12] |
Liu P J, Liu Y P, Ma L K, et al. The predictive ability of two triglyceride-associated indices for gestational diabetes mellitus and large for gestational age infant among Chinese pregnancies: a preliminary cohort study[J]. Diabetes Metab Syndr Obes, 2020, 13: 2025-2035. DOI: 10.2147/DMSO.S251846
|
| [13] |
Song S N, Duo Y B, Zhang Y M, et al. The predictive ability of hepatic steatosis index for gestational diabetes mellitus and large for gestational age infant compared with other noninvasive indices among Chinese pregnancies: a preliminary double-center cohort study[J]. Diabetes Metab Syndr Obes, 2021, 14: 4791-4800. DOI: 10.2147/DMSO.S335364
|
| [14] |
中国营养协会. 中国妇女妊娠期体重监测与评价: T/CNSS 009-2021[S]. 北京: 中国营养协会, 2021.
China Nutrition Association. Weight monitoring and evaluation during pregnancy period of Chinese women: T/CNSS 009-2021[S]. Beijing: China Nutrition Associa-tion, 2021.
|
| [15] |
Simental-Mendía L E, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects[J]. Metab Syndr Relat Disord, 2008, 6(4): 299-304. DOI: 10.1089/met.2008.0034
|
| [16] |
Malhotra R K, Indrayan A. A simple nomogram for sample size for estimating sensitivity and specificity of medical tests[J]. Indian J Ophthalmol, 2010, 58(6): 519-522. DOI: 10.4103/0301-4738.71699
|
| [17] |
Giannini C, Santoro N, Caprio S, et al. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds[J]. Diabetes Care, 2011, 34(8): 1869-1874. DOI: 10.2337/dc10-2234
|
| [18] |
Bao W, Dar S, Zhu Y Y, et al. Plasma concentrations of lipids during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study[J]. J Diabetes, 2018, 10(6): 487-495. DOI: 10.1111/1753-0407.12563
|
| [19] |
Xie J W, Li L, Xing H Y. Metabolomics in gestational diabetes mellitus: a review[J]. Clin Chim Acta, 2023, 539: 134-143. DOI: 10.1016/j.cca.2022.12.005
|
| [20] |
Di Bartolo B A, Cartland S P, Genner S, et al. HDL improves cholesterol and glucose homeostasis and reduces atherosclerosis in diabetes-associated atherosclerosis[J]. J Diabetes Res, 2021, 2021: 6668506.
|
| [21] |
Guerrero-Romero F, Simental-Mendía L E, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp[J]. J Clin Endocrinol Metab, 2010, 95(7): 3347-3351. DOI: 10.1210/jc.2010-0288
|
| [22] |
Li H B, Miao C, Liu W J, et al. First-trimester triglyceride-glucose index and risk of pregnancy-related complications: a prospective birth cohort study in southeast China[J]. Diabetes Metab Syndr Obes, 2022, 15: 3705-3715. DOI: 10.2147/DMSO.S378964
|
| [23] |
Kim J A, Kim J, Roh E, et al. Triglyceride and glucose index and the risk of gestational diabetes mellitus: a nationwide population-based cohort study[J]. Diabetes Res Clin Pract, 2021, 171: 108533. DOI: 10.1016/j.diabres.2020.108533
|
| [24] |
涂梦晗. 三项简易胰岛素抵抗指数对妊娠期糖尿病预测能力的比较研究[D]. 武汉: 华中科技大学, 2022.
Tu M H. Comparison of capability of three simple insulin resistance indices in prediction of gestational diabetes mellitus[D]. Wuhan: Huazhong University of Science and Technology, 2022.
|
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