High serum triglyceride levels in the early first trimester of pregnancy are associated with gestational diabetes mellitus: A prospective cohort study

Aims/Introduction Pregnant women with gestational diabetes mellitus (GDM) have been reported to have higher serum triglyceride (TG) levels during the entire gestational period. However, whether TGs contribute to the incidence of GDM remains unclear. This study aimed to evaluate whether higher serum TG level during early first trimester is associated with GDM. Materials and Methods A prospective single-center cohort study was carried out among pregnant women (n = 2,949) who received regular antenatal care in Fu Xing Hospital, Capital Medical University, Beijing, China. GDM was diagnosed between 24 and 28 gestational weeks. Serum TG levels were measured during gestational weeks 6-8 (TG0) and 16-18 (TG1). TG elevation was the difference between TG1 and TG0. Results In total, 581 pregnant women developed GDM. A 13.1, 18.5 and 28.8% incidence of GDM was observed in women with low, referent and high TG0 levels, respectively. Among women with prepregnancy body mass index <24 kg/m(2) and prepregnancy body mass index >= 24 kg/m(2), those with high TG0 levels had 2.4- and 2.3-fold increased odds of developing GDM, respectively, compared with pregnant women with low TG0 levels. A positive dose-response relationship was observed between continuous TG0 and TG elevation, and the odds of GDM; a positive association was observed between TG elevation and the odds of developing GDM in pregnant women with intermediate to high TG0 levels. Conclusion High TG level during the early first trimester, and TG elevation from the first to early second trimester are associated with GDM development, which persists even after adjusting for confounders.