Relationship between lipid profiles and glycemic control in gestational diabetes mellitus women

BACKGROUND: Gestational diabetes mellitus (GDM), a prevalent pregnancy complication, can adversely impact both maternal and neonatal health post-delivery due to poor glycemic control. Although numerous studies highlight the close association between blood lipids and GDM, the specific correlation between lipid profiles and the prognosis of GDM remains ambiguous. METHODS: This study was conducted at the Women and Children's Hospital of Ningbo University, with data collected between December 2017 and December 2018. A total of 841 GDM participants were categorized into good glycemic control (GGC, N = 524) and poor glycemic control (PGC, N = 317) groups based on ACOG and ADA criteria. Blood lipid indices were analyzed using univariate and multivariate logistic regression analyses, with further stratification by maternal age, parity, and pre-pregnancy BMI. RESULTS: In the third trimester, the PGC group exhibited significantly lower levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) (P < 0.05). Multivariate analysis revealed that a 1 mmol/L increase in HDL-c during late pregnancy reduced the risk of PGC by 54% (OR = 0.46, 95% CI = 0.24-0.89), while a higher triglyceride (TG)/HDL-c ratio increased the risk by 23% (OR = 1.23, 95% CI = 1.02-1.48). Stratified analysis confirmed that among women aged ≤ 35 years, multiparas, and those who were overweight or obese, higher HDL-c served as a protective factor, whereas a greater TG/HDL-c ratio posed a significant risk. CONCLUSION: These findings underscore the critical role of blood lipid metabolism in maintaining glycemic control in GDM, particularly in high-risk populations, such as multiparas and overweight/obese women.