Insulin Resistance Is Associated with an Unfavorable Serum Lipoprotein Lipid Profile in Women with Newly Diagnosed Gestational Diabetes

Biomolecules. 2023 Mar 3;13(3):470. doi: 10.3390/biom13030470.

Abstract

Background: Gestational diabetes (GDM) is associated with various degrees of insulin resistance-a feature related to increased risk of adverse perinatal outcomes. We aimed to determine the previously poorly investigated associations between maternal insulin resistance and serum fasting metabolome at the time of GDM diagnosis.

Methods: Serum lipoprotein and amino acid profile was analyzed in 300 subjects with newly diagnosed GDM using a validated nuclear magnetic resonance spectroscopy protocol. Associations between insulin resistance (homeostasis model assessment of insulin resistance, HOMA2-IR) and serum metabolites were examined with linear regression.

Results: We found insulin resistance to be associated with a distinct lipid pattern: increased concentration of VLDL triglycerides and phospholipids and total triglycerides. VLDL size was positively related and LDL and HDL sizes were inversely related to insulin resistance. Of fatty acids, increased total fatty acids, relative increase in saturated and monounsaturated fatty acids, and relative decrease in polyunsaturated and omega fatty acids were related to maternal insulin resistance.

Conclusions: In newly diagnosed GDM, the association between maternal insulin resistance and serum lipoprotein profile was largely as described in type 2 diabetes. Lifestyle interventions aiming to decrease insulin resistance from early pregnancy could benefit pregnancy outcomes via more advantageous lipid metabolism.

Keywords: GDM; gestational diabetes; insulin resistance; metabolome; metabolomics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes, Gestational* / diagnosis
  • Fatty Acids
  • Female
  • Humans
  • Insulin
  • Insulin Resistance*
  • Lipoproteins
  • Pregnancy
  • Triglycerides

Substances

  • Lipoproteins
  • Triglycerides
  • Fatty Acids
  • Insulin
  • Blood Glucose

Grants and funding

This study was funded by Turku University Hospital Foundation (Turun yliopistollisen keskussairaalan koulutus- ja tutkimussäätiö), Turku, Finland [T.R.], State Funding for University Level Health Research (Valtion määräraha yliopistotasoiseen terveyden tutkimukseen), Helsinki, Finland [M.H.], and Diabetes Research Foundation (Diabetestutkimussäätiö) [T.R.]. The funding sources had no involvement in the analysis or interpretation of the data.