Endocrine Abstracts

Aim: The aim of our study was to describe the lipid profile of Tunisian women after pregnancy with gestational diabetes mellitus (GDM) and to analyze the influence of maternal age, insulin requirement and postpartum glycemic status on lipoproteins changes after pregnancy.

Methods: We conducted a cross-sectional study among pregnant women who were referred to the national institute of nutrition for management of GDM. The lipid profile included total cholesterol (TC), HDL-C (High density lipoprotein-C) and triglycerides (TG). Pregnant women with prior diabetes or prior known dyslipidemia or thyroid disorders were excluded. Subgroups analyses were performed according to categories of maternal age (<35 years versus ≥35 years), insulin requirement (yes versus no) and postpartum glycemic status (normal HGPO, abnormal HGPO).

Results: After pregnancy (23±7.5 Weeks post-partum), mean triglyceride, total cholesterol and HDL cholesterol levels were 1.02±0.68 mmol/l, 1.3±0.23 mmol/l and 5±1.18 mmol/l respectively. An average significant decrease of 43.4±40.8% in triglycerides levels (P=0.002), of 15.4±14.9% in total cholesterol (P=0.001) and of 14±26.6% in HDL cholesterol (P=0.016) was observed. After pregnancy, no woman had isolated hypertriglyceridemia (higher than 1.7 mmol/L), 15% had isolated hypercholesterolemia (higher than 5.2 mmol/L), 30% had mixed hyperlipidemia and 45% had low HDL-C (lower than 1.7 mmol/L). No significant differences in lipids variation were observed according to postpartum glycemic status neither according to maternal age. Insulin-treated patients showed a significant lower decrease of total cholesterol (P=0.035).

Conclusions: Dyslipidemia is a persistent problem in women with gestational diabetes mellitus after pregnancy. Insulin requirement affected the variation of total cholesterol in women with GDM. The development of GDM may be a predict factor of possible future cardiovascular or metabolic disease. The control of the lipid profile after gestational diabetes mellitus can be an interesting opportunity to screen women with dyslipidemia and to institute effective management strategies to reduce this cardiovascular risk factor.