Lack of predictive power of plasma lipids or lipoproteins for gestational diabetes mellitus in Japanese women

Abstract

Aims/introduction: To determine the diagnostic potential of plasma lipids and apolipoproteins in gestational diabetes mellitus (GDM), we carried out a retrospective cohort study of 1,161 Japanese women at 20-28 weeks of gestation who underwent a glucose challenge test (GCT).

Materials and methods: A total of 1,161 Japanese women at 20-28 weeks of gestation underwent a GCT. Participants with a positive test (GCT[+]) underwent a subsequent oral glucose tolerance test. Clinical and biochemical parameters were determined and quantification of apolipoproteins (Apo), including ApoB, ApoB48, ApoA-I and ApoC-III, was carried out.

Results: The prevalence of GCT(+; with a 130 mg/dL glucose cut-off) and GDM was 20% and 4%, respectively. There was a trend for increased triglycerides and ApoC-III in GDM(+) participants. However, the difference in plasma triglycerides, ApoC-III or ApoB48 did not reach statistical significance between GDM(+) and GDM(-) women. Values of 1-h glucose (P < 0.001) and fasting glucose (P = 0.002) were significant risk factors for GDM.

Conclusions: Prediction of GDM using only the ApoC-III value is not easy, although triglycerides and ApoC-III were higher in the GDM(+) group. The present findings show no significant difference in plasma lipid levels between women diagnosed with GDM and those with normal glucose tolerance.

Keywords: Apolipoprotein C-III; Gestational diabetes mellitus; Glucose challenge test.

Figure 1

Baseline and classification based on glucose tolerance. †Participants with a negative glucose challenge test (GCT[−]) were not allowed to undergo an oral glucose tolerance test (OGTT) for ethical reasons to avoid unnecessary stress to the pregnant women. A total of 16 GCT (−) participants completed the OGTT. ‡Not all participants were asked to undergo an OGTT, even with a positive GCT (GCT[+]) result. A first check was carried out at the Japanese Red Cross Medical Center, but deliveries were carried out in the patient's hometown or at other facilities providing no follow-up data.

Figure 2

Changes in plasma glucose and insulin levels of oral glucose tolerance test for glucose challenge test positive participants. (a) Changes in mean plasma glucose concentrations. (b) Changes in mean plasma insulin concentrations. The errors bars represent standard error. (▬) The International Association of Diabetes and Pregnancy Study Group's threshold at each time-point. The International Association of Diabetes and Pregnancy Study Group's definition of gestational diabetes mellitus (GDM) uses a cut-off threshold of glucose 60 min after oral glucose tolerance test of >180 mg/dL. The mean (±standard deviation) concentration of 167.1 ± 4.50 mg/dL in the current study is below this level. ***P < 0.001.