The role of lipid dysregulation in gestational diabetes mellitus: Early prediction and postpartum prognosis

J Diabetes Investig. 2024 Jan;15(1):15-25. doi: 10.1111/jdi.14119. Epub 2023 Dec 14.

Abstract

Gestational diabetes mellitus (GDM) is a pathological condition during pregnancy characterized by impaired glucose tolerance, and the failure of pancreatic beta-cells to respond appropriately to an increased insulin demand. However, while the majority of women with GDM will return to normoglycemia after delivery, they have up to a seven times higher risk of developing type 2 diabetes during midlife, compared with those with no history of GDM. Gestational diabetes mellitus also increases the risk of multiple metabolic disorders, including non-alcoholic fatty liver disease, obesity, and cardiovascular diseases. Lipid metabolism undergoes significant changes throughout the gestational period, and lipid dysregulation is strongly associated with GDM and the progression to future type 2 diabetes. In addition to common lipid variables, discovery-based omics techniques, such as metabolomics and lipidomics, have identified lipid biomarkers that correlate with GDM. These lipid species also show considerable potential in predicting the onset of GDM and subsequent type 2 diabetes post-delivery. This review aims to update the current knowledge of the role that lipids play in the onset of GDM, with a focus on potential lipid biomarkers or metabolic pathways. These biomarkers may be useful in establishing predictive models to accurately predict the future onset of GDM and type 2 diabetes, and early intervention may help to reduce the complications associated with GDM.

Keywords: Biomarkers; Gestational diabetes; Lipid metabolism.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / etiology
  • Diabetes, Gestational* / metabolism
  • Female
  • Humans
  • Lipids
  • Postpartum Period
  • Pregnancy
  • Prognosis

Substances

  • Biomarkers
  • Lipids