Association of lipid profiles and triglyceride-glucose index at the first visit with the risk of gestational diabetes mellitus

Objective To investigate the association of lipid profiles and triglyceride-glucose (TyG) index at the first visit with the risk of gestational diabetes mellitus (GDM). Methods Between June 2014 and February 2018, a total of 545 pregnant women were divided into normal glucose tolerance (NGT, n=157) and GDM (n=388) according to 75 g oral glucose tolerance test. The characteristic and metabolic indexes, such as TyGindex, triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), were comparedusing Student's t-test or Mann-Whitney U test. Logistic regression was used to analyze the risk factors of GDM during pregnancy. Receiver operating characteristic curve predicted the threshold of each indicator affecting the occurrence of GDM. Results The results showed that the level of TG [2.09 (1.44, 2.94) vs 1.47 (1.02, 2.64) mmol/L, Z=-2.169, P=0.030], TyG index [1.75 (1.38, 2.13) vs 1.16 (0.84, 1.70), Z=-3.910, P<0.001], and TG/HDL-C [1.30 (0.86, 1.74) vs 0.96(0.71, 1.44), Z=-2.283, P=0.022] in GDM were significantly higher than NGT. Maternal age, pre-gestational weight, pre-gestational maximum weight, pre-gestational body mass index, proportion of overweight and obesity, prenatal weight, first-degree relatives family history of diabetes, acanthosis, and the incidence of previous adverse pregnancy outcomes were also higher in GDM (P<0.05). Adjusted confounding factors, TyG index [odds ratio (OR)=24.138, 95% confidence interval (CI) 4.167-139.862, P<0.001] was a risk factor for GDM. With the increase of TyG index, the risk of GDM increased significantly (P<0.05). ROC curves showed that the cut-off values of TyG index and TG were 1.38 [sensitivity 75.5% and specificity 65.6%; area under the curve (AUC) 0.730, 95% CI: 0.632-0.827, P<0.001], and 51.59 mmol/L (sensitivity 72.6% and specificity 54.3%; AUC 0.623, 95%CI: 0.513- 0.732, P=0.056), respectively. Conclusion Pregnant women with TyG index>1.38 is prone to occur GDM during pregnancy. Key words: Gestational diabetes mellitus; Oral glucose tolerance test; Triglyceride-glucose index