Association between triglyceride-to-HDL-cholesterol ratio and risk of gestational diabetes mellitus in the first trimester: a retrospective cohort study.

This retrospective cohort study examined the association between first-trimester triglyceride-to-HDL cholesterol (TG/HDL-C) ratio and gestational diabetes mellitus (GDM) risk among 2,356 pregnant women from Shanghai General Hospital between October 2019, and June 2021. Using logistic regression and restricted cubic spline models, we found the TG/HDL-C ratio was an independent GDM predictor (OR:1.37, 95%CI:1.16-1.62, p<0.001), persisting after adjustment (aOR:1.65, 95%CI:1.27-2.13, p<0.001). Nonlinear dose-response relationships were observed (p-interaction<0.05), with stronger associations in women >35 years (OR:1.60, 95%CI:1.12-2.28) and those with BMI≥25kg/m² (OR:1.78, 95%CI:1.25-2.54). First-trimester TG/HDL-C ratio elevation significantly increases GDM risk, suggesting its potential for early risk stratification and targeted prevention.