Association of atherogenic index of plasma with gestational diabetes mellitus and birth weight outcomes, and the mediating role of blood glucose
Doudou Zhao, Yanfang Song, Nan Li, Yu Zhang, Yiting Li, Kangxin Wang, Yang Mi, Lei Shang, Pengfei QuABSTRACT
Aims
This study aimed to examine the associations of maternal first‐trimester atherogenic index of plasma (AIP) with gestational diabetes mellitus (GDM) and birth weight outcomes, and the mediating role of second‐trimester blood glucose.
Methods
This prospective cohort study included 5,706 pregnant women without pre‐existing diabetes or other chronic diseases. AIP was calculated as log 10 [TG (mg/dL)/HDL‐C (mg/dL)] from fasting lipid profiles. Generalized linear models and mediation analysis were used to assess the relationships between AIP and outcomes, and the mediating effects of blood glucose.
Results
Participants had a mean maternal age of 29.3 years, a mean first‐trimester AIP of 0.28 ± 0.19, GDM prevalence of 20.64%, and mean neonatal birth weight of 3314.05 ± 442.11 g. A 1‐unit increase in first‐trimester AIP was associated with greater birth weight (β: 93.12 g, 95% CI: 39.38–146.87), elevated GDM risk (RR: 2.08, 95% CI: 1.52–2.85), and higher risk of large‐for‐gestational‐age infants (RR: 1.67, 95% CI: 1.09–2.58). A nonlinear association was identified between first‐trimester AIP and birth weight, with a 158.95 g (β: 158.95 g, 95% CI: 90.70–227.20) rise per 1‐unit elevation in AIP above 0.14. Fasting plasma glucose (FPG) mediated 28.35% of the association between AIP and birth weight, rising to 60.04% among women with GDM. The third‐trimester rise in AIP was significantly smaller in women with GDM.
Conclusions
First‐trimester AIP appears to correlate with GDM and birth weight. Second‐trimester FPG mediates this association, particularly in mothers with GDM. These findings support the clinical value of early lipid monitoring in prenatal care.