Association between TyHGB and gestational diabetes mellitus: a large-scale retrospective cross-sectional study

Le résumé fourni par la source

TyHGB is a novel indicator reflecting insulin resistance and has been validated in multiple metabolic disorders. However, the relationship between TyHGB and gestational diabetes mellitus (GDM) remains unclear. This study aimed to explore the cross-sectional association between TyHGB and GDM status among pregnant women undergoing routine gestational glucose screening. This retrospective cross-sectional study included 29,042 singleton pregnant women who completed 75 g oral glucose tolerance testing (OGTT) at 24–28 weeks of gestation. Multivariable logistic regression, restricted cubic splines (RCS), and stratified subgroup analyses were performed to evaluate the association and nonlinear dose-response pattern between TyHGB and GDM. Receiver operating characteristic (ROC) analysis was used to assess the concurrent discriminatory ability of TyHGB for GDM at the time of OGTT measurement. GDM was diagnosed in 5,823 of the 29,042 women (20.1%). TyHGB levels were higher in the GDM group than in the non-GDM group, and the prevalence of GDM increased with increasing TyHGB quartiles ( P < 0.001). Before and after adjustment for all potential confounders, multivariable logistic regression analyses showed that TyHGB was associated with the odds of GDM, with the odds of GDM increasing across higher TyHGB quartiles (all P < 0.001). RCS analyses revealed a nonlinear dose-response relationship between TyHGB and GDM. The association between TyHGB and GDM remained consistent across subgroup analyses. Formal interaction tests indicated significant effect modification by maternal age ( P < 0.05), whereas pre-pregnancy BMI showed no modifying effect ( P > 0.05). E-value analysis suggested moderate resistance to potential unmeasured confounding. ROC curve analysis revealed that TyHGB exhibited moderate discriminatory performance for GDM and demonstrated marginally improved discrimination compared with other lipid-derived indices. Higher TyHGB levels are cross-sectionally associated with higher odds of GDM in pregnant women, exhibiting a nonlinear dose-response relationship.

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