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Maternal serum triglyceride, glucose tolerance, and neonatal birth weight ratio in pregnancy
C J Nolan1, S F Riley, M T Sheedy
1Department of Medicine, University of Melbourne, Victoria, Australia.
Insights
Early pregnancy serum triglyceride (TG) levels can predict glucose tolerance and birth weight ratio (BWR). Measuring TG between 9-12 weeks gestation offers moderate predictive value for GDM screening.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Metabolic Disorders
Background:
- Elevated triglycerides (TG) in pregnancy are linked to adverse outcomes.
- Early pregnancy metabolic markers may predict gestational diabetes mellitus (GDM) and birth weight ratio (BWR).
Purpose of the Study:
- To assess the predictive value of early pregnancy serum triglyceride (TG) levels for late-gestation glucose tolerance.
- To determine the association between early TG levels and neonatal birth weight ratio (BWR).
Main Methods:
- Prospective study of 388 pregnant women.
- Nonfasting morning serum TG measured early (12 +/- 6 weeks gestation).
- Oral glucose tolerance test (OGTT) and BWR assessed late in pregnancy (30 +/- 3 weeks gestation).
Main Results:
- Early TG positively correlated with OGTT glucose area under the curve (OGTT-GAUC) (r=0.23, P<0.0001).
- Correlation was strongest when TG measured 9-12 weeks gestation (r=0.35) and in Asian-born women (r=0.71).
- TG positively correlated with BWR in all subjects (r=0.12) and in GDM subjects (r=0.60).
Conclusions:
- Early pregnancy TG measurement (9-12 weeks) has moderate predictive value for glucose tolerance.
- TG predicts BWR in gestational diabetes mellitus (GDM) subjects.
- Metabolic differences observed between Asian-born and Australian/Western European-born women warrant further investigation.
Objective:
To determine the value of measuring serum triglyceride (TG) levels early in pregnancy for predicting late-gestation glucose tolerance and neonatal birth weight ratio (BWR) (birth weight corrected for gestational age).
Research Design And Methods:
The relationships between morning nonfasting TG measured early in pregnancy (gestational age 12 +/- 6 weeks [mean +/- SD]) and glucose tolerance measured by a 3-h 50-g oral glucose tolerance test (OGTT) late in pregnancy (gestational age 30 +/- 3 weeks) and BWR were investigated in 388 women attending routine antenatal care. The data were analyzed for all women in addition to subgroups of Australian/Western European-born (n = 246) and Asian-born (n = 97) women.
Results:
Morning nonfasting TG positively correlated with the OGTT glucose area under the curve (OGTT-GAUC) (r = 0.23, P < 0.0001) in all subjects. This correlation was stronger in the subset of subjects who had TG measured between 9 and 12 weeks of gestation (r = 0.35, P = 0.0001) and was particularly strong in Asian-born women who had TG measured within this period (r = 0.71, P < 0.0001). Mean TG and the 2- and 3-h OGTT values were higher in Asian-born subjects compared with Australian/Western European-born subjects (P = 0.004, P < 0.0001, and P = 0.02, respectively). TG correlated positively with BWR in all subjects (r = 0.12, P = 0.02), in Asian-born subjects (r = 0.23, P = 0.02), and in subjects with gestational diabetes mellitus (GDM) (r = 0.60, P = < 0.001).
Conclusions:
TG, if measured between 9 and 12 weeks of gestation, has moderate predictive value for subsequent glucose tolerance in pregnancy. TG is also predictive of BWR in GDM subjects. Further studies are warranted to investigate the role of early TG measurement in the screening and management of GDM. Metabolic heterogeneity exists between Asian-born and Australian/Western European-born women, the significance of which is still unclear and warrants further study.