[Effect of pre-pregnancy body mass index on first-trimester pregnant women glucose and lipid metabolism].

Objective: To examine the association of pre-pregnancy body mass index(BMI) and first-trimester glucose and lipid metabolism.

Methods: A total of 298 pregnant women with high risk factors for gestational diabetes in early pregnancy, with an average age of 32.24 years, 66.11% were primiparous and the average time for blood collection was 12.5 weeks, were collected from August 2021 to April 2022 at the Department of Nutrition, Haidian District Maternal and Child Health Hospital, Beijing. Pregnant women were divided into low weight group(n=15), normal weight group(n=181), overweight/obese group(n=102) according to their pre-pregnancy BMI. Fasting glucose, fasting insulin, lipid quadruple, C-reactive protein, leptin and adiponectin levels were compared among groups.

Results: (1)Triglyceride concentrations were significantly higher in women in the overweight/obese group(1.51 mmol/L vs.1.15 mmol/L) than in women in low weight group(P<0.01). HDL cholesterol(HDL-C) levels were lower than in women with low weight(1.64 mmol/L vs.1.95 mmol/L)(P<0.01). (2)Pre-pregnancy low weight women had reduced pancreatic β-cell function in early pregnancy with the HOMA-β index of 60.41%, and women in the overweight/obese group had heavier fasting insulin levels(7.86 vs.3.42 μU/mL) and insulin resistance(1.75 vs 0.74) in early pregnancy than low weight women(P<0.01). (3)Pre-pregnancy BMI was positively correlated with triglycerides, fasting insulin, C-reactive protein levels, and degree of insulin resistance in early pregnancy(r=0.30, 0.28, 0.45 and 0.45, P<0.01)and negatively correlated with HDL-C levels in early pregnancy(r=-0.29, P<0.01).

Conclusion: Among pregnant women with risk factors for gestational diabetes, pre-pregnancy overweight and obesity are associated with glucose and lipid metabolism levels in early pregnancy.