Relationship between Serum Lipids in ۱۳-۲۳ Weeks of Pregnancy and Abnormal Glucose Challenge Test

Background and Objective: Gestational diabetes mellitus (GDM) complicates ۳-۵% of all pregnancies. Glucose Challenge Test (GCT) is a universal screening test for GDM between ۲۴-۲۸ of gestation. Plasma glucose is measured ۱ hr after ingestion of ۵۰g glucose load. The aim of this study was to determine the relationship of plasma lipids in ۱۳-۲۳ weeks of pregnancy with abnormal GCT (Glucose Challenge Test). Materials and Methods: This prospective longitudinal study was carried out during ۲۰۱۰-۲۰۱۱. The subjects comprised ۵۷۵ pregnant women aged ۱۸-۳۵ years old who had referred to two health centers (Kosar and Shahid Soleymani) in Shahr rey –Tehran. The subjects were followed until their ۲۴-۲۸ weeks of gestation. Maternal plasma lipid concentrations were measured at ۱۳-۲۳ weeks of gestation and then all participants were screened at ۲۴-۲۸ weeks of gestation with GCT. A value over ۱۴۰mg/dl in GCT was considered positive. Results: Logistic Regression analyses confirmed that triglyceride (TG) concentration (OR=۱.۰۰۵, ۹۵% CI= ۱.۰۰۱-۱.۰۱۰) associated with abnormal GCT. No evidence of association was found between GCT risk and plasma concentrations of other lipids (i.e., total cholesterol, high-density lipoprotein and low-density lipoprotein). In ROC curve analysis, the TG cut-off point in abnormal GCT was ۱۴۲.۵ mg/dl (with ۶۱.۳% sensitivity, ۶۰.۱% specificity, ۷۳% PPV and ۷۴.۶۳% NPV). Conclusion: The findings of this study imply that TG level at ۱۳-۲۳ weeks of pregnancy can be considered as a predictor factor for abnormal GCT.

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Keywords: Gestational diabetes mellitus , Triglyceride , Glucose challenge test , HDL , LDL