Association of lipid accumulation product with Gestational Diabetes Mellitus: a hospital based study
Keywords:
Gestational Diabetes Mellitus, diabetes, obstetrics
Abstract
Background: Gestational Diabetes Mellitus (GDM) is an emerging problem which affects a large number of pregnant women in India. Women with GDM have been shown to have abnormal lipid profiles with higher serum triacylglycerol concentrations but lower LDL levels. Early detection reduces adverse maternal and foetal outcome. The Lipid Accumulation Product (LAP) is an index of fat distribution and assessment which can be easily measured in an outpatient setup.Methods: This study was a hospital based case control study. Cases were 30 pregnant women, newly diagnosed with GDM in their 2nd trimester while controls were 30 apparently healthy pregnant women without risk factors for GDM. Lipid accumulation product (LAP) was computed by multiplying a sex-specific estimate of waist circumference and the fasting triglyceride concentration, LAP = (WC [cm] - 58) x TGL [mmol/L].Result: The mean age of patients with GDM was higher when compared to controls. (28.17 ± 3.34 vs 24.40 ± 3.07, p < 0.0001) The lipid profile showed a significantly higher value of serum triglycerides among cases while the differences in HDL were not statistically significant. Lipid accumulation product (LAP) in GDM patients was found to be significantly elevated when compared to controls. (133.43 ± 64.02 vs 62.89 ± 30.68, p < 0.0001)Conclusion: Calculation of LAP can be done to identify the degree of risk for developing GDM. So LAP can possibly serve as in future as a screening tool for the diagnosis of GDM in an outpatient setting in resource poor settings. DOI: 10.21276/AWCH.1461References
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2..American Diabetes Association: Gestational diabetes mellitus (Position Statement). DiabetesCare 27 (Suppl. 1):S88–S90, 2004
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6. Brisson D, Perron P, Guay SP, Gaudet D, Bouchard L. The ‘‘hypertriglyceridemic waist’’ phenotype and glucose intolerance in pregnancy. CMAJ 2010;182:E722–E725.
7. Lemieux I, Poirier P, Bergeron J, et al. Hypertriglyceridemic waist: a useful screening phenotype in preventive cardiology? Can J Cardiol 2007;23:23B-31B.
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9.Unger RH: Minireview: Weapons of Lean Body Mass Destruction: The Role of Ectopic Lipids in the Metabolic Syndrome. Endocrinology 2003, 144:5159-5165.
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11.Unger RH: Lipid overload and overflow: metabolic trauma and the metabolic syndrome. Trends Endocrinol Metab 2003, 14:398-403
12.Linda A Barbour, MD, MSPH,Carrie E. Mccurdy, PHD,Teri L. Hernandez, RN, MS John P. Kirwan, PHD,Patrick M. Catalano, MD Jacob E. Friedman, PHD Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes Diabetes care:30(2) , JULY 2007
13. Basaran A (2009) Pregnancy-induced hyperlipoproteinemia: review of the literature.
Reproductive sciences 16:431-437.
14. Montes A, Walden CE, Knopp RH, Cheung M, Chapman MB, Albers JJ (1984) Physiologic and supraphysiologic increases in lipoprotein lipids and apoproteins in late
pregnancy and postpartum. Possible markers for the diagnosis of "prelipemia". Arteriosclerosis 4:407-417.
15.Sanchez-Vera I, Bonet B, Viana M, Quintanar A, Martin MD, Blanco P, et al. (2007)
Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation
in pregnancies complicated by gestational diabetes: consequences of obesity.
Metabolism 56:1527-1533.
16.Kahn HS: The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population based comparison. BMC Cardiovasc Disord 2005, 5:26.
17. De Souza LR, Kogan E, Berger H, et al. Abdominal adiposity and insulin resistance in early pregnancy.J 80. Montelongo A, Lasuncion MA, Pallardo LF & Herrera E. Longitudinal study of plasma lipoproteins and hormones during pregnancy in normal and diabetic women. Diabetes 1992; 41: 1651–1659.
18.Hollingsworth DR, Grundy SM. Pregnancy-associated hypertriglyceridemia in normal and diabetic women. Differences in insulin-dependent, non-insulindependent, and gestational diabetes. Diabetes. 1982;31(12):1092–7.
19. Koukkou E, Watts GF, Lowy C. Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study. J Clin Pathol. 1996;49(8):634–7.
20. Rizzo M, Berneis K, Altinova AE et al. Atherogenic lipoprotein phenotype and LDL size and subclasses in women with gestational diabetes. Diabet Med 2008; 25: 1406–1411.Obstet Gynaecol Can 2014;36:969–975
21. Raghuram Pusukur, Arjun S. Shenoi, Prakash KumarKyada, Babita Ghodke, Varshil Mehta, Kunal Bhuta, Aadhijaya Bhatia.Evaluation of Lipid Profile in Second and Third Trimester of Pregnancy.Journal of Clinical and Diagnostic Research. 2016 Mar, Vol-10(3): QC12-QC16
22. J.-Y. Oh, Y.-A. Sung and H. J. Lee. The lipid accumulation product as a useful index foridentifying abnormal glucose regulation in young Korean women. Diabet. Med. 30, 436–442 (2013).
.
2..American Diabetes Association: Gestational diabetes mellitus (Position Statement). DiabetesCare 27 (Suppl. 1):S88–S90, 2004
3.Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesityrelated health risk factors, 2001. JAMA. 2003;289(1):76-9.
4. Bower JF, Hadi H, Barakat HA. Plasma lipoprotein subpopulation distribution in Caucasian and African-American women with gestational diabetes. Diabetes Care 2001;24:169–171
5. D. Gasevic, J. Frohlich, G. B. J. Mancini, and S. A. Lear, “The association between triglyceride to high-density-lipoprotein cholesterol ratio and insulin resistance in a multiethnic primary prevention cohort,” Metabolism: Clinical and Experimental,vol. 61, no. 4, pp. 583–589, 2012.
6. Brisson D, Perron P, Guay SP, Gaudet D, Bouchard L. The ‘‘hypertriglyceridemic waist’’ phenotype and glucose intolerance in pregnancy. CMAJ 2010;182:E722–E725.
7. Lemieux I, Poirier P, Bergeron J, et al. Hypertriglyceridemic waist: a useful screening phenotype in preventive cardiology? Can J Cardiol 2007;23:23B-31B.
8.D.A.Enquobahrie,M.A.Williams,C.Qiu,andD.A.Luthy, “Early pregnancy lipid concentrations and the risk of gestational diabetes mellitus,” Diabetes Research and Clinical Practice,vol. 70,no.2,pp.134–142,2005
9.Unger RH: Minireview: Weapons of Lean Body Mass Destruction: The Role of Ectopic Lipids in the Metabolic Syndrome. Endocrinology 2003, 144:5159-5165.
10.Schaffer JE: Lipotoxicity: when tissues overeat. Curr Opin Lipidol 2003, 14:281-287.
11.Unger RH: Lipid overload and overflow: metabolic trauma and the metabolic syndrome. Trends Endocrinol Metab 2003, 14:398-403
12.Linda A Barbour, MD, MSPH,Carrie E. Mccurdy, PHD,Teri L. Hernandez, RN, MS John P. Kirwan, PHD,Patrick M. Catalano, MD Jacob E. Friedman, PHD Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes Diabetes care:30(2) , JULY 2007
13. Basaran A (2009) Pregnancy-induced hyperlipoproteinemia: review of the literature.
Reproductive sciences 16:431-437.
14. Montes A, Walden CE, Knopp RH, Cheung M, Chapman MB, Albers JJ (1984) Physiologic and supraphysiologic increases in lipoprotein lipids and apoproteins in late
pregnancy and postpartum. Possible markers for the diagnosis of "prelipemia". Arteriosclerosis 4:407-417.
15.Sanchez-Vera I, Bonet B, Viana M, Quintanar A, Martin MD, Blanco P, et al. (2007)
Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation
in pregnancies complicated by gestational diabetes: consequences of obesity.
Metabolism 56:1527-1533.
16.Kahn HS: The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population based comparison. BMC Cardiovasc Disord 2005, 5:26.
17. De Souza LR, Kogan E, Berger H, et al. Abdominal adiposity and insulin resistance in early pregnancy.J 80. Montelongo A, Lasuncion MA, Pallardo LF & Herrera E. Longitudinal study of plasma lipoproteins and hormones during pregnancy in normal and diabetic women. Diabetes 1992; 41: 1651–1659.
18.Hollingsworth DR, Grundy SM. Pregnancy-associated hypertriglyceridemia in normal and diabetic women. Differences in insulin-dependent, non-insulindependent, and gestational diabetes. Diabetes. 1982;31(12):1092–7.
19. Koukkou E, Watts GF, Lowy C. Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study. J Clin Pathol. 1996;49(8):634–7.
20. Rizzo M, Berneis K, Altinova AE et al. Atherogenic lipoprotein phenotype and LDL size and subclasses in women with gestational diabetes. Diabet Med 2008; 25: 1406–1411.Obstet Gynaecol Can 2014;36:969–975
21. Raghuram Pusukur, Arjun S. Shenoi, Prakash KumarKyada, Babita Ghodke, Varshil Mehta, Kunal Bhuta, Aadhijaya Bhatia.Evaluation of Lipid Profile in Second and Third Trimester of Pregnancy.Journal of Clinical and Diagnostic Research. 2016 Mar, Vol-10(3): QC12-QC16
22. J.-Y. Oh, Y.-A. Sung and H. J. Lee. The lipid accumulation product as a useful index foridentifying abnormal glucose regulation in young Korean women. Diabet. Med. 30, 436–442 (2013).
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Published
2017-05-28
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