Cord blood Advanced Lipoprotein Testing shows an interaction between gestational diabetes and birth-weight: an observational study

Background Abnormal lipid metabolism is observed in gestational diabetes mellitus (GDM) and in neonates with abnormal fetal growth, however, how these alterations specifically affect the umbilical cord blood lipoprotein profile is not well understood. Objective To assess the impact of GDM on the cord blood lipoprotein profile across birth-weight categories by using Advanced Lipoprotein Testing. Methods observational study involving 74 control and 62 GDM pregnant women and their offspring. Newborns were classified according to birth-weight as small (n = 39), adequate (n = 50) or large (n = 49) for gestational age (SGA, AGA and LGA, respectively). Two-dimensional diffusion-ordered 1H-NMR spectroscopy was used to profile umbilical cord serum lipoproteins. One hundred and three children were available in a two years follow-up study to evaluate associations between cord blood lipid profile and obesity. Results Baseline characteristics of the two groups were similar except for gestational weight gain. The size, lipid content, number and concentration of particles within their subclasses were similar between offspring born to GDM and control mothers. Using two-way analysis of variance, we observed an interaction between GDM and birth-weight categories for IDL-cholesterol content and IDL- and LDL-triglyceride content, and the number of medium VLDL and LDL particles, specifically in AGA neonates. Small LDL particles were independently associated with offspring obesity at two years. Conclusions In this selected cohort, GDM disturbs triglyceride and cholesterol lipoprotein content across birth-weight categories, and AGA neonates born to GDM mothers display a profile more similar to adults with dyslipidemia and atherosclerosis than to those born to mothers with normal glucose tolerance.