High TG/HDL-C ratio suggests a higher risk of gestational diabetes mellitus in the first trimester

Abstract Objective: To investigate the relationship between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and gestational diabetes mellitus (GDM) in the first trimester. Method(s): We followed 2,356 pregnant women who visited the obstetric outpatient clinic of Shanghai General Hospital and underwent regular obstetric examinations from October 1st, 2019 to June 1st, 2021. A 75 g oral glucose tolerance test (OGTT) was performed, and lipid levels were measured in the first trimester. Logistic regressionand restricted cubic spline (RCS) were applied to evaluate the association between the TG/HDL-C ratio and GDM. Result(s): Among 2,356 pregnant women, 425 women(18.04 %) were diagnosed with GDM. Logistic regression analysis showed that the TG/HDL-C ratio was an independent risk factor for GDM (OR=1.37 (95% CI: 1.16-1.62), p<0.001). After adjusting for potential confounding factors, we observed that a high TG/HDL-C ratio promoted GDM (OR: 1.65, 95% CI: 1.27–2.13, p<0.001). The RCS analysis revealed a signifcant nonlinear association. (P-interaction < 0.05). Conclusion(s): In this study, we found a significant correlation between TG/HDL-C ratio and GDM, and high TG/HDL-C ratio can be regarded as a significant risk factor for the development of gestational diabetes. Early detection of elevated TG/HDL-C may serve in early detection of GDM and help physicians in framing primary preventive strategies.