Endocrine Abstracts

Aims: Maternal dyslipidemia during pregnancy is more serve in GDM women compared with non–GDM women. The occurrence of postpartum hyperglycemia is associated with increased lipid profiles. The purpose of this study was to evaluate the relationship between lipid changes and early postpartum abnormal glucose metabolism (AGM) of women with prior GDM history.

Methods: 395 patients with a history of GDM who had a postpartum OGTT were included in this retrospective cohort study. Patients’ lipid levels at the gestational 2nd, 3rd trimester and early postpartum, which included total cholesterol (TC), triglycerides (TG), low–density lipoprotein cholesterol (LDL–C), high–density lipoprotein cholesterol (HDL–C) and TG/HDL–C ratio were recorded. HOMA–IR was used to evaluate insulin resistance and ISSI–2 was applied to assess pancreatic β cell functions. Logistic regression and Spearman correlation analysis were applied to determine the relationship between postpartum lipid change and glucose metabolism.

Result: Postpartum AGM patients (n = 153) were with higher postpartum triglycerides (TG) and TG/HDL levels than women with normal glucose tolerance (NGT) (n = 242). TG, TC, LDL–C, concentration and TG/ HDL–C ratio increased gradually during pregnancy and decreased after delivery, while HDL–C levels constantly decreased from 2nd trimester to early postpartum, the trends were similar in the postpartum AGM group and NGT group. Logistic regression analysis showed that decrease ratio of TG after delivery was associated with a decreased risk of early postpartum AGM. Correlation analysis indicated that ratio of TC, TG, LDL–C and TG/HDL–C were associated with the restoring of insulin sensitivity and pancreatic β cell function.

Conclusion: Postpartum changes in blood lipid level in GDM patients are closely related to hyperglycemia in the early postpartum, and effect of the decrease of TG was the most significant. The specific mode of action may be related to insulin resistance and pancreatic β cell function.