Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression

<i>Background and Objectives</i>: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounce...

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Main Authors: Milos Milincic, Andja Cirkovic, Katarina Ivanovic, Stefan Dugalic, Miroslava Gojnic Dugalic
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1290
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author Milos Milincic
Andja Cirkovic
Katarina Ivanovic
Stefan Dugalic
Miroslava Gojnic Dugalic
author_facet Milos Milincic
Andja Cirkovic
Katarina Ivanovic
Stefan Dugalic
Miroslava Gojnic Dugalic
author_sort Milos Milincic
collection DOAJ
description <i>Background and Objectives</i>: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. <i>Materials and Methods</i>: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I<sup>2</sup> statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. <i>Results</i>: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, <i>p</i> < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; <i>p</i> < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, <i>p</i> < 0.001 for both, LDL-C: SMD = 0.33, 0.20, <i>p</i> < 0.001 for both), in pregnant women with GDM compared to those without the condition. <i>Conclusions</i>: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management.
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spelling doaj-art-47aa54ab380b4bf8a79b237d2957bfc92025-08-20T02:47:22ZengMDPI AGMedicina1010-660X1648-91442025-07-01617129010.3390/medicina61071290Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-RegressionMilos Milincic0Andja Cirkovic1Katarina Ivanovic2Stefan Dugalic3Miroslava Gojnic Dugalic4Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, SerbiaInstitute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia<i>Background and Objectives</i>: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. <i>Materials and Methods</i>: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I<sup>2</sup> statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. <i>Results</i>: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, <i>p</i> < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; <i>p</i> < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, <i>p</i> < 0.001 for both, LDL-C: SMD = 0.33, 0.20, <i>p</i> < 0.001 for both), in pregnant women with GDM compared to those without the condition. <i>Conclusions</i>: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management.https://www.mdpi.com/1648-9144/61/7/1290lipid profilegestational diabetes mellituspregnancytriglyceridescholesterol
spellingShingle Milos Milincic
Andja Cirkovic
Katarina Ivanovic
Stefan Dugalic
Miroslava Gojnic Dugalic
Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
Medicina
lipid profile
gestational diabetes mellitus
pregnancy
triglycerides
cholesterol
title Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
title_full Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
title_fullStr Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
title_full_unstemmed Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
title_short Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
title_sort trimester specific serum lipid profiles in gestational diabetes mellitus a systematic review meta analysis and meta regression
topic lipid profile
gestational diabetes mellitus
pregnancy
triglycerides
cholesterol
url https://www.mdpi.com/1648-9144/61/7/1290
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