April 13, 2016
2 min read
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Prepregnancy lipid profile may identify women at risk for gestational diabetes

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In women who developed gestational diabetes, lower HDL concentration and LDL peak diameter size and higher concentrations of small and very small LDL particles were present years before pregnancy, according to study findings.

Evaluation of a prepregnancy atherogenic lipid profile may help identify women at risk for gestational diabetes, the researchers wrote.

Emily S. Han, MPH, of the division of research at Kaiser Permanente Northern California, and colleagues evaluated data from 254 women who developed gestational diabetes and two controls without a history of gestational diabetes for each case to determine whether a prepregnancy lipid profile can predict development of gestational diabetes. Blood from the women was collected and stored between 1984 and 1996, and the women had a subsequent pregnancy between 1984 and 2009.

In the fully adjusted model, compared with the highest (reference) quartile, participants with a prepregnancy LDL peak diameter in the lowest quartile were more than twice as likely to develop gestational diabetes (OR = 2.6; 95% CI, 1.37-4.94).

Increased odds of developing gestational diabetes were linked with increasing concentration of the smallest LDL particles (P < .01 for trend). Compared with the lowest quartile, increased odds of developing gestational diabetes were linked to the two highest quartiles (quartile 3, OR = 1.99; 95% CI, 1.05-3.75; quartile 4, OR = 2.44; 95% CI, 1.22-4.85). Concentration of medium-sized LDL particles was linked to increased odds of gestational diabetes with increasing quartile concentrations (P < .01 for trend).

Odds of developing gestational diabetes were nearly twice as high for women in the lowest two quartiles of total HDL particle concentration compared with women in the highest quartile (quartile 1, OR = 1.98; 95% CI, 1.01-3.86; quartile 2, OR = 1.92; 95% CI, 1.02-3.62).

“A lipoprotein profile including smaller LDL peak particle diameter, lower HDL levels and higher levels of small, dense LDL, determined on average 7 years before pregnancy, is associated with increased likelihood for developing [gestational diabetes],” the researchers wrote. “While a causal mechanism for this association remains to be identified, our findings are consistent with the possibility that improving the cardiometabolic risk profile in women of reproductive age may reduce the risk of [gestational diabetes]. LDL size and subfraction measurements in reproductive-aged women may be helpful to identify those at risk of [gestational diabetes] to target for early treatment and prevention efforts.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.