Correlation Analysis Between The LDL/HDL Ratio,TG/HDL Ratio And Gestational Diabetes Mellitus In The Second Trimester Of Pregnancy

Objective:To explore the relationship between the LDL/HDL ratio,TG/HDL ratio in the second trimester of pregnancy in patients with gestational diabetes mellitus(GDM)?Methods:Using the retrospective study method,selected 1597 patients of obstetric examination and childbirth from June 2018 to June 2019 in Kunshan first hospital maternity clinic inspection and production,which 573 pregnant women with gestational diabetes mellitus as group GDM,and another 1024 normal glucose tolerance pregnant women as group NGT.The general data of pregnant women were recorded,including age,height,gestational times,birth times,weight before pregnancy,weight gain during pregnancy,gestational weeks after delivery,and the related indexes of lipid metabolism of 16 to 20 weeks of pregnancy,as well as the related information of delivery mode and pregnancy outcome.The difference of lipid metabolism between GDM group and NGT group in the second trimester and the relationship between the difference of blood glucose control and the lipid metabolism in the second trimester of GDM.The correlation between LDL/HDL and TG/HDL ratio and birth weight of GDM pregnant women and the effect of LDL/HDL and TG/HDL ratio on pregnancy outcome were analyzed.Results:1.There was no significant difference in gestational age,gestational times,birth times,weight before pregnancy,gestational weeks and BMI before pregnancy between GDM group and NGT group(P>0.05).But there was significant difference in weight gain in late pregnancy,birth weight and delivery mode of newborn(P<0.05).2.The TG,LDL,LDL/HDL ratio and TG/HDL ratio in GDM group were significantly higher than those in NGT group,the differences were statistically significant.While the HDL in GDM group was significantly lower than that in NGT group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in TC,LP-a,apolipoprotein A,apolipoprotein B,TC/HDL ratio(P>0.05).3.In GDM group,TG,LDL,apolipoprotein B,LDL/HDL ratio and TG/HDL ratio of OGTT time-glycemic AUC?16.8 mmol/L/h group were significantly higher than those of OGTT time-glycemic AUC<16.8 mmol/L/h group(P<0.05),while HDL of the former was significantly lower than that of the latter(t=2.937,P<0.05).There was no significant difference in TC,LP-a,apolipoprotein A and TC/HDL ratio between the former and the latter(P>0.05).4.ROC curve analysis showed that LDL/HDL ratio could effectively predict the risk of serious illness in GDM patients(AUC=0.626,95%CI 0.579-0.673,P=0.000).The best cut point value was 1.87,and the sensitivity and specificity were 71.9%and 49.1%,respectively.Meanwhile,TG/HDL ratio has the same effect(AUC=0.599,95%CI It was 0.549-0.648,P=0.000).The best cut point was 2.23,and the sensitivity and specificity were 53.6%and 66.6%,respectively.5.The correlation analysis of LDL/HDL ratio,TG/HDL ratio and newborn birth weight in the second trimester of GDM showed that the correlation coefficient between LDL/HDL ratio and newborn birth weight was r=0.082,P=0.049,and the correlation coefficient between TG/HDL ratio and newborn birth weight was r=0.157,P=0.000.That is to say,the correlation between LDL/HDL ratio and TG/HDL ratio in the second trimester of GDM group and newborn birth weight were both positive.6.TG is the risk factor of GDM pregnant women giving birth to macrosomia,OR is 2.835;HDL is the protective factor of GDM pregnant women giving birth to macrosomia,OR is 0.002.7.The incidence of GDM pregnant women in macrosomia,preterm delivery,postpartum hemorrhage and pregnancy hypertension was significantly higher than that in NGT group(P<0.05).8.The 95th percentile of LDL/HDL ratio and TG/HDL ratio in NGT group were used as the reference interval of LDL/HDL ratio and TG/HDL ratio respectively.When LDL/HDL was more than 2.87 in the GDM group,the incidence of macrosomia,oligohydramnios,postpartum hemorrhage and neonatal asphyxia increased significantly(P<0.05).When TG/HDL was more than 4.59,the incidence of macrosomia,fetal distress and neonatal asphyxia also increased significantly increased(P<0.05).Conclusion:There is imbalance of lipid metabolism in GDM pregnant women.LDL/HDL,TG/HDL ratio in the second trimester of pregnancy can predict the severity of GDM,and have a positive correlation with the birth weight of the newborn,which can be used to estimate the birth weight of the newborn.