Abstract
BACKGROUND: The primary complication associated with gestational diabetes mellitus (GDM) is delivery of an infant that is large for gestational age (LGA). Epidemiological findings have demonstrated that irregular lipid metabolism significantly contributes to insulin resistance, a key pathophysiological mechanism in GDM. However, the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent. AIM: To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females. METHODS: Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95% confidence intervals for LGA according to five lipid indices. Restricted cubic spline models were applied to investigate dose-response relationships. The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups. Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices. RESULTS: Across crude and adjusted models, females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category. Conversely, high-density lipoprotein cholesterol levels demonstrated the contrary trend. Restricted cubic spline analyses revealed linear associations between the five lipid indices, except triglyceride levels, and the prevalence of LGA. The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent. The five lipid indices presented significant diagnostic efficacy, as indicated by receiver operating characteristic curve areas. CONCLUSION: Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.