LDL to HDL ratio

This study investigated the associations between lipid profiles in early pregnancy, stratified by body mass index (BMI), and the risk of developing gestational diabetes mellitus (GDM). A prospective cohort of 2,488 healthy pregnant women was analyzed, with fasting plasma lipid profiles—including triglycerides (TG), total cholesterol (CHO), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)—measured at a mean gestation of 11 weeks. Multivariable logistic regression was used to estimate the relative risk of GDM. The results showed that GDM cases exhibited significantly higher levels of TG, CHO, LDL, and LDL/HDL ratios, and lower HDL concentrations compared to controls (P < 0.01). After adjusting for confounders, a TG concentration ≥ 1.58 mmol/L was associated with a 1.8-fold increased risk of GDM in lean women (95% CI: 1.2–2.7) and a 2.7-fold increased risk in obese women (95% CI: 1.1–6.6). Conversely, lean women with HDL concentrations ≥ 2.22 mmol/L exhibited a 50% reduced risk of GDM (95% CI: 0.3–0.9). No significant correlations between other lipid parameters and GDM risk were found. These findings suggest that early pregnancy dyslipidemia, characterized by high TG or low HDL levels, is a significant risk factor for GDM, with BMI further modifying these associations.