Abstract
OBJECTIVE: The aim of the study was to evaluate the association between triglycerides/high-density lipoprotein-cholesterol (TG/HDL) ratio and cardiometabolic risk factors in children of mothers who had gestational diabetes (GDM). METHODS: This retrospective cohort study involved 227 offspring aged 2-14 years, born to mothers with GDM. Data was collected during routine antenatal care, and the offspring were evaluated 2-14 years later. TG/HDL ratio was stratified into tertiles. Cardiometabolic risk factors were defined according to the World Health Organization (WHO) criteria for children: obesity, overweight, elevated waist circumference, elevated blood pressure and hypertension, dysglycemia, low HDL-cholesterol, and elevated TG. The association of TG/HDL ratio and cardiometabolic risk factors was evaluated through comparative and linear regression analysis. RESULTS: There were higher mean levels of some markers of cardiometabolic risk factors according to TG/HDL ratio tertiles. We observed higher frequencies of elevated HbA1c from 2 to 4 years (0 vs. 3.7 vs. 12.9%, p-linear-by-linear <0.001); higher prevalence of overweight/obesity from 5 to 9 years (39.1 vs. 47.2 vs. 75.0%, p-linear-by-linear<0.001), and higher frequencies of elevated low density lipoprotein-cholesterol from 10 to 14 years (33.3 vs. 66.6 vs. 77.7%, p-linear-by-linear=0.044) according to TG/HDL ratio tertiles. TG/HDL ratio was associated with homeostasis model assessment-insulin resistance from 5 to 9 years (β0.11 [95% confidence interval (95%CI) 0.00-0.23]) and from 10 to 14 years (β0.10 [95%CI 0.02-0.18]), after adjustments for sex and body mass index. CONCLUSIONS: Our results show that higher levels of TG/HDL ratio are associated with worse cardiometabolic profile and insulin resistance in offspring from mothers who had gestational diabetes mellitus and can be a good marker to identify those at higher cardiometabolic risk.