Serum triglyceride to high density lipoprotein cholesterol ratio in late pregnancy as a potential predictor of adverse birth outcomes: an analysis of real-world data.

IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Bin Zhang, Zhaolong Zhan, Feng Zhang, Sijie Xi, Xiaosong Yuan, Zhonghua Shi
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Abstract

Background: The association between serum triglyceride to high density lipoprotein cholesterol ratio (THR) in late pregnancy and adverse birth outcomes (ABO) remains controversial because of inconsistent results. The present study assessed the association between maternal serum THR and incidence of ABO [preterm birth (PTB), small and large for gestational age (SGA/LGA), low birth weight (LBW) and macrosomia] in a Chinese population.

Methods: A total of 11,553 consecutive participants from a real-world database with data on lipid profiles and birth outcomes were included. Logistic regression models were applied to assess the association between THR and incident ABO. Mediation analysis was performed to investigate the contribution of pregnancy complications [gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP) and pre-eclampsia (PE)] to this association.

Results: Approximately 6.6% (762/11,553), 8.9% (1023/11,553), 15.5% (1792/11,553), 4.3% (494/11,553), and 7.4% (851/11,553) of individuals developed PTB, SGA, LGA, LBW and macrosomia, respectively. Significant trends across the quintiles of THR toward decreasing incidence of SGA and LBW and increasing incidence of LGA and macrosomia were observed. The multivariate-adjusted odds ratios (OR) in the top quintile of serum THR (> 3.16) versus the bottom quintile (< 1.44) were 0.52 for PTB, 0.48 for SGA, 0.64 for LBW, 2.80 for LGA and 3.80 for macrosomia, respectively. A 1-standard deviation (SD) increase in serum THR was associated with decreased risk of PTB [OR = 0.84, 95% confidence interval (CI): 0.76-0.93), SGA (OR = 0.71, 95% CI:0.65-0.78) and LBW (OR = 0.76, 95% CI:0.65-0.90) and increased risk of LGA (OR = 1.40, 95% CI:1.32-1.49) and macrosomia (OR = 1.49, 95% CI:1.38-1.62). In mediation analyses, PE mediated - 19.8%, -10.6% and - 24.6% of THR-associated PTB, SGA and LBW, respectively, GDM accounted for - 3.7%, 6.8% and 4.3% of THR-associated PTB, LGA and macrosomia, respectively, and ICP explained - 1.9% and - 2.1% of THR-associated PTB and LBW, respectively. In addition, incorporating THR to ABO predictive models significantly improved the area under the curve for SGA (0.743 vs. 0.753, P < 0.001), LGA (0.734 vs. 0.745, P < 0.001) and macrosomia (0.786 vs. 0.800, P < 0.001).

Conclusion: Real-world data showed an association between serum THR in late pregnancy and ABO risk, and this association may be partially mediated by prevalent pregnancy complications (PE/GDM/ICP), suggesting a potential role of THR in predicting ABO (SGA/LGA/macrosomia).

妊娠晚期血清甘油三酯与高密度脂蛋白胆固醇比值作为不良分娩结局的潜在预测因素:真实世界数据分析。
背景:由于结果不一致,孕晚期血清甘油三酯与高密度脂蛋白胆固醇比值(THR)与不良出生结局(ABO)之间的关系仍存在争议。本研究评估了中国人群中母体血清甘油三酯与 ABO [早产(PTB)、小胎龄和大胎龄(SGA/LGA)、低出生体重(LBW)和巨大儿]发生率之间的关系:方法:纳入了来自真实世界数据库的 11,553 名连续参与者,这些参与者具有血脂概况和出生结局数据。采用逻辑回归模型评估 THR 与 ABO 事件之间的关联。对妊娠并发症[妊娠糖尿病(GDM)、妊娠肝内胆汁淤积症(ICP)和先兆子痫(PE)]对这种关联的影响进行了中介分析:分别约有 6.6% (762/11,553)、8.9% (1023/11,553)、15.5% (1792/11,553)、4.3% (494/11,553) 和 7.4% (851/11,553) 的人罹患 PTB、SGA、LGA、LBW 和巨大儿。在 THR 的五分位数中,观察到 SGA 和 LBW 的发生率呈显著下降趋势,而 LGA 和巨大儿的发生率呈显著上升趋势。经多变量调整后,血清 THR 最高五分位数(> 3.16)与最低五分位数(结论:血清 THR 最高五分位数与最低五分位数之间的几率比(OR)为 3.16:真实世界的数据显示,孕晚期血清总胆红素与 ABO 风险之间存在关联,这种关联可能部分受妊娠并发症(PE/GDM/ICP)的影响,这表明总胆红素在预测 ABO(SGA/LGA/巨大儿)方面具有潜在作用。
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来源期刊
Diabetology & Metabolic Syndrome
Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-
CiteScore
6.20
自引率
0.00%
发文量
170
审稿时长
7.5 months
期刊介绍: Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.
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