The Impact Of Gestational Diabetes Mellitus On Neonatal Lipid Metabolism And Growth

Objective: To investigate the impact of gestational diabetes mellitus on neonatal lipid metabolism and growth.Methods and materials: Pregnant women from the department of Gynaecology and Obstetrics in First People's Hospital, Shanghai Jiao Tong University were enrolled in the study and divided into two groups: 50 pregnant women with normal glucose tolerant?NGT group? and 55 pregnant women with gestational diabetes mellitus?GDM group?. The level of maternal peripheral blood serum triglyceride?TG?, cholesterol?TC?, high-density lipoprotein cholesterol?HDL-C?, low density lipoprotein cholesterol?LDL-C?, Apo A ?, Apo B₁₀₀, Apo C ?, glycated albumin, glycated hemoglobin were obtained antepartum. At birth, fetal umbilical venous blood was obtained to detect the level of blood glucose and serum TG, TC, HDL-C, LDL-C, Apo A ?, Apo B₁₀₀, Apo C ?. Birth length, birth weight, head circumference, chest circumference, abdomen circumference, upper arm circumference, shoulder width, total skinfolds were measured within 24 h of birth.Results:?1? Compared with NGT group, women of GDM group had higher pre-gestational BMI?P<0.01?, lower gestational weight gain?P<0.01?,decreased antepartum serum level of TC, HDL-C, LDL-C, Apo A ?, Apo B₁₀₀ and Apo C ??P<0.01?,increased serum level of glycated albumin, glycated hemoglobin?P<0.01?, but no significance was found in age and TG?P>0.05?.?2? Compared with infants of NGT group, infants of GDM group had increased Apo B₁₀₀?P<0.05?, decreased Apo A ?, Apo C ??P<0.01?,but no significance was found in umbilical venous blood glucose and umbilical venous serum level of TG, TC, HDL-C and LDL-C?P>0.05?.?3? Compared with NGT group, infants of GDM group had increased risk of macrosomia?P<0.05? and larger chest circumference, abdomen circumference, shoulder width and total skinfolds?P<0.01?. But no significance was found in birth weight, birth length and upper arm circumference?P>0.05?.?4? Multiple linear regression analysis showed that GDM was inversely associated with Apo A ??regression coefficients???:-94.47, P<0.0001? and Apo C ???:-22.86, P<0.0001? of neonatal umbilical venous blood. GDM was positively associated with Apo B₁₀₀ of neonatal umbilical venous blood??:0.03, P=0.019?.?5? Logistic regression analysis showed GDM increased the risk of macrosomia?OR=6.75, P<0.0001?. Multiple linear regression analysis showed that GDM was positively associated with neonatal birth weight??:0.25, P=0.0198?, chest circumference??:2.81, P<0.0001?, abdomen circumference??:2.09, P<0.0001?, shoulder width??:0.58, P=0.0121? and total skinfolds??:5.64, P<0.0001?.?6? Multiple linear regression analysis showed that Apo A ? was inversely associated with neonatal abdomen circumference??:-0.01, P<0.0001? and total skinfolds?? :-0.035, P<0.0001?. Apo C III was inversely associated with neonatal chest circumference?? :-0.08, P<0.0001?.Conclusion: Compared with NGT group, neonates of GDM group had increased Apo B₁₀₀, decreased Apo A ? and Apo C ? in umbilical venous blood. Meanwhile, neonates of GDM had higher neonatal fat mass, increased birth weight, chest circumference, abdomen circumference, shoulder width and risk of macrosomia. Lower Apo A ? was associated with increased abdomen circumference and higher fat mass, while lower Apo C III level was associated with increased chest circumference. It needs prospective cohort study and further research to elucidate the mechanism of GDM on neonatal growth by regulating lipid metabolism.