Gestational Diabetes Associated With Increased Risk for Future Dyslipidemia

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A history of gestational diabetes is associated with increased risk for dyslipidemia.

A history of gestational diabetes is associated with increased risk for dyslipidemia, according to study results published in BMJ Open Diabetes Research & Care.

Women with a history of gestational diabetes are at increased risk of developing several cardiovascular risk factors, but the relationship with dyslipidemia remains unknown. Using data collected from 160,527 women who were members of Maccabi Healthcare Services in Israel, researchers aimed to assess the effect of gestational diabetes on postpartum lipid levels.

Pregnant women were screened between 24 and 28 weeks of gestation for diabetes by glucose challenge test. A follow-up oral glucose tolerance test was performed to diagnose gestational diabetes. Triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were analyzed individually over follow-up (mean duration, 11 years). Dyslipidemia was defined as TG levels >200 mg/dL, LDL-C levels >160 mg/dL, and HDL-C levels <40 mg/dL.

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Within the historical cohort, 10,234 women (6.4%) were diagnosed with gestational diabetes. During follow-up, 2.1 million lipid tests were performed. Women with previous gestational diabetes were found to have a 5 mg/dL increase in TG levels and a 0.7 mg/dL decrease in HDL-C levels compared with those without. A history of gestational diabetes was also associated with a 1.8-fold increased risk (95% CI, 1.73-1.88) for dyslipidemia defined by TG levels, 1.45-fold increased risk (95% CI, 1.38-1.52) when defined by LDL-C levels, and 1.44-fold increased risk (95% CI, 1.39-1.50) when defined by HDL-C levels.

The study authors noted that they were unable to fully characterize the metabolic characteristics of women before or after pregnancy, including information on diet, which may have had effects on lipid levels.

“[O]ur results demonstrate that women with previous [gestational diabetes] present significant increase in the risk of dyslipidemia,” the researchers concluded. “[I]ncreased awareness among caregivers, as well as postnatal interventions, should begin early after delivery focusing on healthy lifestyle modification to ameliorate the excess future risk of dyslipidemia and its complications.”

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Chodick G, Tenne Y, Barer Y, Shalev V, Elchalal U. Gestational diabetes and long-term risk for dyslipidemia: a population-based historical cohort study. BMJ Open Diabetes Res Care. 2020;8:e000870.