PDF(Pubmed)
Abstract：
This study aims to determine the association of pregnancy cholesterol metabolism markers with gestational diabetes mellitus (GDM) risk. We performed a nested case-control study in the Tongji Birth Cohort. GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24-28 gestational weeks. Nine cholesterol metabolism markers were detected using gas chromatography-mass spectrometry. Conditional logistic regression models were conducted. A total of 444 pregnant women were matched in a 1:2 ratio. The cholestanolTC and β-sitosterolTC in cholesterol absorption markers presented negative associations with the risks of GDM (adjusted OR: 0.77, 95% CI: 0.61-0.96; adjusted OR: 0.80, 95% CI: 0.64-1.00). The desmosterolTC in cholesterol synthesis markers were positively associated with the risks of GDM (adjusted OR: 1.25, 95% CI: 1.00-1.56), similar in the ratios of cholesterol synthesis to absorption markers. After adjustment for insulin or HOMA-IR, these effects were reduced. In conclusion, higher cholesterol synthesis and lower cholesterol absorption marker levels in the first pregnancy are associated with a higher risk of GDM, and insulin resistance may play a vital role in this association.
摘要：
这项研究旨在确定妊娠胆固醇代谢标志物与妊娠糖尿病（GDM）风险的关系。我们在同济出生队列中进行了嵌套病例对照研究。在24-28孕周根据75g2h口服葡萄糖耐量试验（OGTT）诊断为GDM。使用气相色谱-质谱法检测了9种胆固醇代谢标志物。采用条件logistic回归模型。共有444名孕妇以1：2的比例进行匹配。胆固醇吸收标志物中的cholestanolTC和β-谷甾醇TC与GDM的风险呈负相关（校正OR：0.77，95％CI：0.61-0.96；校正OR：0.80，95％CI：0.64-1.00）。胆固醇合成标志物中的desmosterolTC与GDM的风险呈正相关（校正OR：1.25，95％CI：1.00-1.56），胆固醇合成与吸收标记的比例相似。调整胰岛素或HOMA-IR后，这些影响减少了。总之,较高的胆固醇合成和较低的胆固醇吸收标志物水平在第一次怀孕与更高的GDM的风险。胰岛素抵抗可能在这种关联中起着至关重要的作用。
