Remnant cholesterol ups GDM risk in pregnant women

Increased levels of remnant cholesterol (RC) appear to elevate the risk of gestational diabetes mellitus (GDM), independent of traditional risk factors, suggests a study. Moreover, pregnant women with high prepregnancy body mass index (BMI), high triglyceride (TG), and high RC levels are at greater GDM risk.

Data from the Tongji Maternal and Child Health Cohort, a prospective cohort study in China, were used in this analysis. The authors measured fasting lipid concentration in 2,528 women around 16 weeks’ gestation and calculated RC as total cholesterol minus low- and high-density lipoprotein cholesterols. GDM was diagnosed using a 75-g oral glucose tolerance test at 24‒28 weeks’ gestation.

Finally, the authors estimated the relative risks (RRs) of GDM across quartiles of RC levels and TG levels after adjusting for potential confounders using log-Poisson regression models. TG and RC were mutually adjusted.

One in 10 pregnant women (n=256, 10.1 percent) developed GDM. The adjusted RRs for GDM across increasing RC quartiles were 1.00 (reference), 1.35 (95 percent confidence interval [CI], 0.91‒1.99), 1.68 (95 percent CI, 1.16‒2.45), and 1.73 (95 percent CI, 1.19‒2.50), respectively.

GDM risk was higher in pregnant women with normal pre-BMI but high RC (adjusted RR, 1.54, 95 percent CI, 1.08‒2.19) or high TG (adjusted RR, 2.15, 95 percent CI, 1.33‒3.49) than in those without three risk indicators (TG <2.08 mmol/L, RC <0.40 mmol/L, and pre-BMI <24.0 kg/m²). Notably, GDM risk was highest in women with all three risk indicators (adjusted RR, 4.80, 95 percent CI, 3.20‒7.18).