Serum values of atherogenic index of plasma and lipid ratios in gestational diabetes mellitus

Document Type : Original Article

Author

Associate professor, Department of Biochemistry and Genetics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.

Abstract

Introduction: Gestational diabetes mellitus (GDM) can increase the risks for type 2 diabetes, metabolic syndrome and cardiovascular diseases after pregnancy. Lipids are biomarkers that can give valuable information in this aspect. This study was performed with aim to assess serum values of lipids, lipid ratios and atherogenic index of plasma (AIP) and their relationship with maternal age and GDM.
Methods: This case-control study was performed on 52 women with GDM and 59 normal pregnant women referred to Asalian hospital of Khorramabad, Iran during 2013-2014. Serum values of cholesterol, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) were measured using commercially available kits and low-density lipoprotein cholesterol (LDL-C) was calculated. Data were analyzed by SPSS software (version 19), and Kolmogorov – Smirnov, Independent t-test, Pearson’s correlation and regression. PResults: Values of TC/HDL-C ratio (P<0.001), LDL-C/HDL-C ratio (P<0.001) and AIP (P<0.001) were significantly increased while values of HDL-C (P<0.001) and HDL ratio (P<0.001) were significantly decreased in GDM group compared with normal pregnancy; the differences remained significant after adjusting for age of the subjects. The results of logistic regression analysis showed that before and after adjusting for age of the subjects, HDL-C and HDL ratio were negative risk factors for GDM and TC/HDL-C ratio, LDL-C/HDL-C ratio and AIP were positive risk factors for GDM.
Conclusion: Increased TC/HDL-C ratio, LDL-C/HDL-C ratio, and AIP and decreased HDL-C and HDL ratio could be considered risk factors for GDM. Regularly measurements of lipid ratios and interventions for regulation of them might significantly prevent the prevalence of GDM and caused cardiovascular disease especially at postpartum period.

Keywords


  1. Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil 2013; 15(40):16-23. (Persian).
  2. Zangeneh M, Veisi F, Ebrahimi B, Rezavand N. Comparison of therapeutic effects of insulin and glibenclamide in gestational diabetes. Iran J Obstet Gynecol Infertil 2014; 17(124):1-7. (Persian).
  3. Manshori A, Rezaeian M, Bagheri H, Aminzadeh F, Goujani R. Assessment of the appropriate cut-off point in glucose challenge test based on the risk of gestational diabetes in pregnant women. Iran J Obstet Gynecol Infertil 2015; 18(152):1-8. (Persian).
  4. Gongora MC, Wenger NK. Cardiovascular complications of pregnancy. Int J Mol Sci 2015; 16(10):23905-28.
  5. Takhshid MA, Haem Z, Aboualizadeh F. The association of circulating adiponectin and + 45 T/G polymorphism of adiponectin gene with gestational diabetes mellitus in Iranian population. J Diabetes Metab Disord 2015; 14:30.
  6. dos Santos-Weiss IC, Réa RR, Fadel-Picheth CM, Rego FG, Pedrosa Fde O, Gillery P, et al. The plasma logarithm of the triglyceride/HDL-cholesterol ratio is a predictor of low risk gestational diabetes in early pregnancy. Clin Chim Acta 2013; 418:1-4.
  7. Korkmazer E, Solak N. Correlation between inflammatory markers and insulin resistance in pregnancy. J Obstet Gynaecol 2015; 35(2):142-5.
  8. Liang Z, Wu Y, Zhu X, Fang Q, Chen D. Insulin resistance and lipid profile during an oral glucose tolerance test in women with and without gestational diabetes mellitus. J Obstet Gynaecol 2016; 36(3):337-9.
  9. Stein S, Stepan H, Kratzsch J, Verlohren M, Verlohren HJ, Drynda K, et al. Serum fibroblast growth factor 21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia. Metabolism 2010; 59(1):33-7.
  10. Jia X, Wang S, Ma N, Li X, Guo L, Liu X, et al. Comparative analysis of vaspin in pregnant women with and without gestational diabetes mellitus and healthy non-pregnant women. Endocrine 2015; 48(2):533-40.
  11. Li SM, Wang WF, Zhou LH, Ma L, An Y, Xu WJ, et al. Fibroblast growth factor 21 expressions in white blood cells and sera of patients with gestational diabetes mellitus during gestation and postpartum. Endocrine 2015; 48(2):519-27.
  12. Iimura Y, Matsuura M, Yao Z, Ito S, Fujiwara M, Yoshitsugu M, et al. Lack of predictive power of plasma lipids or lipoproteins for gestational diabetes mellitus in Japanese women. J Diabetes Investig 2015; 6(6):640-6.
  13. Wang D, Xu S, Chen H, Zhong L, Wang Z. The associations between triglyceride to high-density lipoprotein cholesterol ratios and the risks of gestational diabetes mellitus and large-for-gestational-age infant. Clin Endocrinol (Oxf) 2015; 83(4):490-7.
  14. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37(Suppl 1):S81-90.
  15. Khosrowbeygi A, Kaviani M, Ahmadvand H, Nassimidoost M. Comparison of serum levels of leptin and adiponectin in pregnant women with gestational diabetes and healthy pregnant women. Iran J Obstet Gynecol Infertil 2014; 16(84):1-9. (Persian).
  16. Khosrowbeygi A, Shiamizadeh N, Taghizadeh N. Maternal circulating levels of some metabolic syndrome biomarkers in gestational diabetes mellitus. Endocrine 2016; 51(2):245-55.
  17. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18(6):499-502.
  18. Pandya N, Santani D, Jain S. Antioxidant activity of ezetimibe in hypercholesterolemic rats. Indian J Pharmacol 2006; 38(3):205-6.
  19. Niroumand S, Khajedaluee M, Khadem-Rezaiyan M, Abrishami M, Juya M, Khodaee G, et al. Atherogenic Index of Plasma (AIP): a marker of cardiovascular disease. Med J Islam Repub Iran 2015; 29:240.
  20. López-Tinoco C, Roca M, Fernández-Deudero A, García-Valero A, Bugatto F, Aguilar-Diosdado M, et al. Cytokine profile, metabolic syndrome and cardiovascular disease risk in women with late-onset gestational diabetes mellitus. Cytokine 2012; 58(1):14-9.
  21. Saucedo R, Zarate A, Basurto L, Hernandez M, Puello E, Galvan R, et al. Relationship between circulating adipokines and insulin resistance during pregnancy and postpartum in women with gestational diabetes. Arch Med Res 2011; 42(4):318-23.
  22. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015; 122(5):643-51.