Women with gestational diabetes mellitus, controlled for plasma glucose level, exhibit maternal and fetal dyslipidaemia that may warrant treatment

Aims: To compare maternal and fetal cord plasma and lipoprotein triglyceride (TG) concentrations in women with Gestational Diabetes Mellitus (GDM), with hyperglycaemia and hypertriglyceridaemia, and healthy women. Methods: Fasted maternal blood at 28.6 +/- 3.4 (T1) and 36.2 +/- 1.0 (T2) [mean +/- S.D] weeks of gestation, and cord blood were collected. Plasma lipoprotein fractions underwent compositional analysis. Results: Plasma glucose did not differ between GDM and healthy women. T1 maternal plasma TG (2.60 +/- 0.89 mmol/l versus 1.71 +/- 0.69 mmol/l) and plasma apolipoprotein B (1.30 +/- 0.48 g/l versus 0.75 +/- 0.40 g/l) were higher in GDM compared to healthy. Maternal plasma TG increased over gestation in both groups. T1 plasma VLDL total protein (38 +/- 15 mg/dl versus 25 +/- 11 mg/dl), total cholesterol (TC) (30 +/- 14 mg/dl versus 16 +/- 13 mg/dl) and phospholipid (PL) (43 +/- 17 mg/dl versus 26 +/- 16 mg/dl) were higher in GDM than healthy, and similarly for IDL, suggesting increased lipoprotein particle number. T1 VLDL-TG enrichment was higher in healthy and increased over gestation in GDM women but decreased in healthy. IDL-TG enrichment (TG/TC) increased over gestation in women with GDM and decreased in healthy. Cord blood VLDL, IDL and LDL from GDM had a two-fold higher TG enrichment than healthy pregnancy. Conclusion: Increased maternal lipoprotein number, but not TG enrichment, in GDM mothers may explain TG enrichment of cord lipoproteins.