Accessible Requires Authentication Published by De Gruyter May 15, 2015

Biological and biochemical characteristics of a Mediterranean population with Gestational Diabetes Mellitus

Charles Savona-Ventura, Josanne Vassallo, Johann Craus, Eleni Anastasiou, Aleksandra Jotic, Nebojsa M. Lalic, Claude Ben Slama, Adele Rovira Loscos, Angela Napoli and Giona Roma


The interplay of various nutrients provided to the developing foetus determines the growth potential of the conceptus. This study assessed the inter-relationship between these nutrients in a Mediterranean population including 1062 pregnant, previously non-diabetic women. These underwent an oral glucose tolerance test (oGTT) and were accordingly classified into gestational hyperglycaemic and normoglycaemic groups. Fasting insulin, HbA1c, and lipid profiles were further assessed, and the anthropomorphic characteristics of the mother and child at birth were measured. Lipid profiles were compared between the two groups and related to the biological characteristics of the mother and child at birth. Gestational hyperglycaemia was significantly associated with elevated triglycerides (P<0.0001) and decreased low density lipoprotein cholesterol (LDL-C) (P=0.02). There were no significant changes in total cholesterol and high density lipoprotein cholesterol (HDL-C) levels. Maternal BMI correlated positively with the various glycaemic indices (P<0.0001) and triglycerides (P<0.0001), but inversely with cholesterol (P<0.0001), HDL-C (P<0.0001) and LDL-C (P<0.0001). The infant birth weight correlated positively with maternal body weight (P<0.0001), LDL-C (P<0.0001) and the glycaemic indices (P<0.0001), but negatively with cholesterol (P<0.0001), triglycerides (P<0.0001), HDL-C (P<0.0001) and FBG (P<0.0001). This study confirms that the maternal body mass index (BMI), insulin resistance, and LDL-C levels positively contribute towards foetal growth, whereas a negative correlation was noted with cholesterol, triglycerides, and HDL-C.

Corresponding author: Charles Savona-Ventura, Department of Obstetrics and Gynaecology, University of Malta, School Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta, E-mail: ; and Department of Health – Obstetrics and Gynaecology, University of Malta, Mater Dei Hospital, Tal-Qroqq, Msida, Malta


[1] Pedersen J. The pregnant diabetic and her newborn: problems and management. Baltimore: Williams and Wilkins; 1967. Search in Google Scholar

[2] Catalano PM, Hauquel-De Mouzon S. Is it time to revisit the Pedersen hypothesis in the face of the obesity epidemic? Am J Obstet Gynecol. 2011;204:479–87. Search in Google Scholar

[3] King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nut. 2000;71:1218s–25s. Search in Google Scholar

[4] Hollingsworth DR, Grundy SM. Pregnancy associated hypertriglyceridemia in normal and diabetic women: differences in insulin-dependent, non-insulin dependent and gestational diabetes. Diabetes. 1982;31:1092–7. Search in Google Scholar

[5] Koukkou E, Watts GF, Lowy C. Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study. J Clin Pathol. 1996;49:634–7. Search in Google Scholar

[6] Knopp RH, Chapman M, Bergelin R, Wahl PW, Warth MR, Irvine S. Relationships of lipoprotein lipids to mild fasting hyperglycemia and diabetes in pregnancy. Diabetes Care. 1980;3:416–20. Search in Google Scholar

[7] Montelongo A, Lasunción MA, Pallardo LF, Herrera E. Longitudinal study of plasma lipoproteins and hormones during pregnancy in normal and diabetic women. Diabetes. 1992;41:1651–9. Search in Google Scholar

[8] Rizzo M, Berneis K, Altinova AE, Toruner FB, Akturk M, Ayvaz G, et al. Atherogenic lipoprotein phenotype and LDL size and subclasses in women with gestational diabetes. Diabet Med. 2008;25:1406–11. Search in Google Scholar

[9] Göbl CS, Handisurya A, Klein K, Bozkurt L, Luger A, Bancher-Todesca D, et al. Changes in serum lipid levels during pregnancy in type 1 and type 2 diabetic subjects. Diabetes Care. 2010;33:2071–3. Search in Google Scholar

[10] Sánchez-Vera I, Bonet B, Viana M, Quintanar A, Martín MD, Blanco P, et al. Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation in pregnancies complicated by gestational diabetes: consequences of obesity. Metabolism. 2007;56:1527–33. Search in Google Scholar

[11] Savvidou M, Nelson SM, Makgoba M, Messow CM, Sattar N, Nicolaides K. First-trimester prediction of gestational diabetes mellitus: examining the potential of combining maternal characteristics and laboratory measures. Diabetes. 2010;59:3017–22. Search in Google Scholar

[12] Clark CM Jr., Qiu C, Amerman B, Porter B, Fineberg N, Aldasouqi S, et al. Gestational diabetes: should it be added to the syndrome of insulin resistance? Diabetes Care. 1997;20:867–71. Search in Google Scholar

[13] Herrera E, Ortega-Senovilla H. Disturbances in lipid metabolism in diabetic pregnancy – Are these the cause of the problem. Best Pract Res Clin Endocr Met. 2010;24:515–26. Search in Google Scholar

[14] Knopp RH, Magee MS, Walden CE, Bonet B, Benedetti TJ. Prediction of infant birth weight by GDM screening tests. Importance of plasma triglyceride. Diabetes Care. 1992;15:1605–13. Search in Google Scholar

[15] Kitajima M, Oka S, Yasuhi I, Fukuda M, Rii Y, Ishimaru T. Maternal serum triglyceride at 24–32 weeks’ gestation and newborn weight in nondiabetic women with positive diabetic screens. Obstet Gynecol. 2001:97:776–80. Search in Google Scholar

[16] Vrijkotte TG, Krukziener N, Hutten BA, Vollebregt KC, van Eijsden M, Twickler MB. Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study. J Clin Endocrinol Metab. 2012;97:3917–25. Search in Google Scholar

[17] World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Geneva: WHO; 2013. Search in Google Scholar

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-1-19
Accepted: 2015-3-20
Published Online: 2015-5-15
Published in Print: 2016-5-1

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