Apolipoprotein Profile in Early Pregnancy and the Link to Gestational Diabetes Mellitus: Insights From Odense Child Cohort.

OBJECTIVES

We aimed to investigate the potential associations between serum apolipoprotein levels in early pregnancy and the risk of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.

METHODS

This was an observational study of the population-based Odense Child Cohort. Pregnant women were followed from inclusion until childbirth. Apolipoprotein levels, including 12 apolipoproteins (ApoA-I, ApoA-II, ApoA-IV, ApoB, ApoC-I, ApoC-II, ApoC-III, ApoD, ApoE, ApoH, ApoJ, and ApoM) were measured by targeted proteomics using liquid chromatography mass spectrometry on late first trimester serum samples stored in a biobank. GDM was defined by WHO 2013 diagnostic criteria.

RESULTS

A total of 991 pregnant women were included, of which 415 (41.9%) were diagnosed with GDM. GDM was associated with increasing ApoB (adjusted odds ratio [OR]: 1.26, P = .002) and ApoD levels (adjusted OR: 0.84, P = .021). ApoB levels in early pregnancy correlated significantly and positively with insulin resistance (r = 0.22, P < .001) and beta-cell function in third trimester (r = 0.20, P < .001), whereas early pregnancy ApoD levels were inversely correlated with insulin resistance (r = -0.14, P < .001) and beta-cell function (r = -0.12, P < .001). Finally, high levels of ApoD was significantly associated with lower risk of large-for-gestational-age infants (adjusted OR: 0.78, P = .041).

CONCLUSIONS

High levels of ApoB and low levels of ApoD in early pregnancy were independently associated with an increased risk of GDM, insulin resistance, and large-for-gestational-age infants (low ApoD only), suggesting potential roles for future management of pregnancy outcomes.