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Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM).
Eur J Obstet Gynecol Reprod Biol. 2020 Jan 13; 246:67-71.EJ

Abstract

OBJECTIVE

The association between gestational diabetes mellitus (GDM) and maternal dyslipidemia is well established, however, the role of obesity in this relationship is not well defined. We examined the relationship between maternal obesity at the first prenatal visit and fasting lipids measured at the time of the oral glucose tolerance test (OGTT) in women screened selectively for GDM.

STUDY DESIGN

This prospective observational study was conducted in a large university maternity hospital. Women were recruited at the first prenatal visit following measurement of their weight and height. Clinical and sociodemographic details were recorded. Women with maternal risk factors for GDM were screened selectively with a one-step 75 g OGTT at 26-28 weeks gestation. GDM was diagnosed based on the World Health Organization (WHO) 2013 criteria. Fasting lipids were measured simultaneously. Maternal lipid levels and their relationship with GDM and obesity were analysed with linear and logistic models.

RESULTS

Of the 275 women recruited at the first antenatal visit 202 attended for their OGTT at 26-28 weeks' and 53.5 % (108) had GDM based on the WHO criteria. The women with GDM were more likely to have obesity (70.4 % vs. 42.6 %, P < 0.001). Compared with women with a normal OGTT (n=94), women with GDM had higher triglycerides (P=0.023) and a lower HDL-Cholesterol (P = 0.013). However, when the cohort with GDM were stratified according to obesity, this trend was only seen in the women who had a BMI >29.9kg/m2. Based on tertiles, women with GDM had a higher odds ratio of increased triglycerides (odds ratio 3.2 (95 % confidence interval; 1.4-6.9), P = 0.004) and lower HDL-Cholesterol (odds ratio 2.2, (95 % confidence interval; 1.1-4.7), P = 0.036) and an increased TG:HDL-cholesterol ratio (odds ratio 2.3, (95 % confidence interval; 1.1-4.9), P = 0.026), only if they had obesity.

CONCLUSION

Our findings suggest that the epidemiological association between GDM and dyslipidemia is mediated through maternal obesity. Women with obesity alone or GDM alone did not have an elevated OR for dyslipidemia. Interventions designed to optimise maternal lipids should prioritise women with obesity and it may be preferable for these interventions to start prior to conception.

Authors+Show Affiliations

UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. Electronic address: eimer.omalley@ucd.ie.UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.Dept. of Biochemistry, Coombe Women & Infants University Hospital, Dublin, Ireland.Dept. of Biochemistry, Coombe Women & Infants University Hospital, Dublin, Ireland.UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31962258

Citation

O'Malley, Eimer G., et al. "Maternal Obesity and Dyslipidemia Associated With Gestational Diabetes Mellitus (GDM)." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 246, 2020, pp. 67-71.
O'Malley EG, Reynolds CME, Killalea A, et al. Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM). Eur J Obstet Gynecol Reprod Biol. 2020;246:67-71.
O'Malley, E. G., Reynolds, C. M. E., Killalea, A., O'Kelly, R., Sheehan, S. R., & Turner, M. J. (2020). Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM). European Journal of Obstetrics, Gynecology, and Reproductive Biology, 246, 67-71. https://doi.org/10.1016/j.ejogrb.2020.01.007
O'Malley EG, et al. Maternal Obesity and Dyslipidemia Associated With Gestational Diabetes Mellitus (GDM). Eur J Obstet Gynecol Reprod Biol. 2020 Jan 13;246:67-71. PubMed PMID: 31962258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM). AU - O'Malley,Eimer G, AU - Reynolds,Ciara M E, AU - Killalea,Anne, AU - O'Kelly,Ruth, AU - Sheehan,Sharon R, AU - Turner,Michael J, Y1 - 2020/01/13/ PY - 2019/11/27/received PY - 2019/12/30/revised PY - 2020/01/10/accepted PY - 2020/1/22/pubmed PY - 2020/1/22/medline PY - 2020/1/22/entrez KW - Dyslipidemia KW - Gestational diabetes mellitus KW - Glucose tolerance test KW - Maternal obesity KW - Pregnancy KW - Triglycerides SP - 67 EP - 71 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 246 N2 - OBJECTIVE: The association between gestational diabetes mellitus (GDM) and maternal dyslipidemia is well established, however, the role of obesity in this relationship is not well defined. We examined the relationship between maternal obesity at the first prenatal visit and fasting lipids measured at the time of the oral glucose tolerance test (OGTT) in women screened selectively for GDM. STUDY DESIGN: This prospective observational study was conducted in a large university maternity hospital. Women were recruited at the first prenatal visit following measurement of their weight and height. Clinical and sociodemographic details were recorded. Women with maternal risk factors for GDM were screened selectively with a one-step 75 g OGTT at 26-28 weeks gestation. GDM was diagnosed based on the World Health Organization (WHO) 2013 criteria. Fasting lipids were measured simultaneously. Maternal lipid levels and their relationship with GDM and obesity were analysed with linear and logistic models. RESULTS: Of the 275 women recruited at the first antenatal visit 202 attended for their OGTT at 26-28 weeks' and 53.5 % (108) had GDM based on the WHO criteria. The women with GDM were more likely to have obesity (70.4 % vs. 42.6 %, P < 0.001). Compared with women with a normal OGTT (n=94), women with GDM had higher triglycerides (P=0.023) and a lower HDL-Cholesterol (P = 0.013). However, when the cohort with GDM were stratified according to obesity, this trend was only seen in the women who had a BMI >29.9kg/m2. Based on tertiles, women with GDM had a higher odds ratio of increased triglycerides (odds ratio 3.2 (95 % confidence interval; 1.4-6.9), P = 0.004) and lower HDL-Cholesterol (odds ratio 2.2, (95 % confidence interval; 1.1-4.7), P = 0.036) and an increased TG:HDL-cholesterol ratio (odds ratio 2.3, (95 % confidence interval; 1.1-4.9), P = 0.026), only if they had obesity. CONCLUSION: Our findings suggest that the epidemiological association between GDM and dyslipidemia is mediated through maternal obesity. Women with obesity alone or GDM alone did not have an elevated OR for dyslipidemia. Interventions designed to optimise maternal lipids should prioritise women with obesity and it may be preferable for these interventions to start prior to conception. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/31962258/Maternal_obesity_and_dyslipidemia_associated_with_gestational_diabetes_mellitus_(GDM) L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(20)30007-5 DB - PRIME DP - Unbound Medicine ER -
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