脂质体
妊娠期糖尿病
医学
四分位间距
2型糖尿病
糖尿病
前瞻性队列研究
内科学
怀孕
队列研究
产科
队列
内分泌学
妊娠期
脂质代谢
生物
遗传学
作者
Guoying Wang,Jessie P. Buckley,Tami R. Bartell,Xiumei Hong,Colleen Pearson,Xiaobin Wang
出处
期刊:Diabetes Care
[American Diabetes Association]
日期:2023-04-12
卷期号:46 (6): 1223-1230
摘要
OBJECTIVE To identify a postpartum lipidomic signature associated with gestational diabetes mellitus (GDM) and investigate the role of the identified lipids in the progression to type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS This prospective cohort study enrolled 1,409 women at 24–72 h after delivery of a singleton baby and followed them prospectively at the Boston Medical Center. The lipidome was profiled by liquid chromatography-tandem mass spectrometry. Diagnoses of GDM and incident T2D were extracted from medical records and verified using plasma glucose levels. RESULTS Mean (SD) age of study women at baseline was 28.5 (6.6) years. A total of 219 (16.4%) women developed incident diabetes over a median follow-up of 11.8 (interquartile range 8.2–14.8) years. We identified 33 postpartum lipid species associated with GDM, including 16 inverse associations (primarily cholesterol esters and phosphatidylcholine plasmalogens), and 17 positive associations (primarily diacyglycerols and triacyglycerols). Of these, four were associated with risk of incident T2D and mediated ∼12% of the progression from GDM to T2D. The identified lipid species modestly improved the predictive performance for incident T2D above classical risk factors when the entire follow-up period was considered. CONCLUSIONS GDM was associated with a wide range of lipid metabolic alterations at early postpartum, among which some lipid species were also associated with incident T2D and mediated the progression from GDM to T2D. The improvements attained by including lipid species in the prediction of T2D provides new insights regarding the early detection and prevention of progression to T2D.
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