Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis.

Background Lipid levels during pregnancy in women with gestational diabetes mellitus ( GDM) have been extensively studied; however, it remains unclear whether dyslipidaemia is a potential marker of preexisting insulin resistance. Objective To evaluate the relationship between lipid measures throughout pregnancy and GDM. Search strategy We searched Pub Med- Med Line and SCOPUS (inception until January 2014) and reference lists of relevant studies. Selection criteria Publications describing original data with at least one raw lipid (total cholesterol, high-density lipoprotein cholesterol [ HDL-C], low-density lipoprotein cholesterol [ LDL-C], or triglyceride) measurement during pregnancy in women with GDM and healthy pregnant controls were retained. Data collection and analysis Data extracted from 60 studies were pooled and weighted mean difference ( WMD) in lipid levels was calculated using random effects models. Meta-regression was also performed to identify sources of heterogeneity. Main results Triglyceride levels were significantly elevated in women with GDM compared with those without GDM ( WMD 30.9, 95% confidence interval [95% CI] 25.4-36.4). This finding was consistent in the first, second and third trimesters of pregnancy. HDL-C levels were significantly lower in women with GDM compared with those without GDM in the second ( WMD −4.6, 95% CI −6.2 to −3.1) and third ( WMD −4.1, 95% CI −6.5 to −1.7) trimesters of pregnancy. There were no differences in aggregate total cholesterol or LDL-C levels between women with GDM and those without insulin resistance. Author's conclusions Our meta-analysis shows that triglycerides are significantly elevated among women with GDM compared with women without insulin resistance and this finding persists across all three trimesters of pregnancy. [ABSTRACT FROM AUTHOR]