Previous Gestational Diabetes Increases Atherogenic Dyslipidemia in Subsequent Pregnancy and Postpartum

Lipids. 2018 Apr;53(4):387-392. doi: 10.1002/lipd.12040. Epub 2018 May 6.

Abstract

In a cohort of women with previous gestational diabetes mellitus (GDM), we aimed to ascertain whether women with abnormal glucose tolerance 1-year postdelivery had a more atherogenic lipid profile during and after pregnancy than those with normal glucose tolerance. A prospective cohort study with longitudinal design between January 2004 and March 2016 was conducted. Three hundred and six (56.8%) of 537 women diagnosed with GDM during the studied period attended a control visit during the first year after delivery. Of these, 112 (36.6%) had prediabetes and 16 (5.2%) had type 2 diabetes mellitus. No significant differences during pregnancy were found in total, low-density lipoprotein, high-density lipoprotein (HDL) cholesterol, and triacylglycerol (TAG) concentrations among the three groups. Only HDL cholesterol and TAG levels differed significantly among groups at 2 and 12 months after delivery. Logistic regression analysis revealed pregnancy HDL and glucose metabolism status to be associated with the HDL cholesterol concentration 1-year postdelivery. Furthermore, the only independent factor associated with TAG levels 1 year after delivery was the gestational TAG concentration. In summary, an overweight multiethnic group of women with prior GDM presented a high incidence of postpartum dysglycemia (41.8%). HDL-cholesterol and TAG levels, both components of the metabolic syndrome, differed significantly among the three study groups in the glucose-metabolism status at 2 and 12 months after delivery. Women with previous GDM must be followed up in the postpartum period for early detection and management of lipid and glucose disorders.

Keywords: Diabetes; Hyperlipidemia; Lipid analysis; Lipid metabolism.

MeSH terms

  • Adult
  • Atherosclerosis / blood
  • Atherosclerosis / metabolism
  • Blood Glucose / metabolism
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / metabolism
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / metabolism*
  • Dyslipidemias / blood
  • Dyslipidemias / complications*
  • Dyslipidemias / metabolism
  • Female
  • Glucose Tolerance Test
  • Humans
  • Postpartum Period / blood
  • Postpartum Period / metabolism*
  • Pregnancy
  • Prospective Studies
  • Regression Analysis
  • Triglycerides / blood
  • Triglycerides / metabolism

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Triglycerides