Capillary Triglycerides in Late Pregnancy-Challenging to Measure, Hard to Interpret: A Cohort Study of Practicality.

Helen L Barrett,Marloes Dekker Nitert,H David Mcintyre,Barbara Lingwood,Susan De Jersey,Leonie K Callaway,Michael D’Emden

doi:10.3390/nu13041266

Helen L Barrett, Marloes Dekker Nitert + Show 5 more

Open Access

https://doi.org/10.3390/nu13041266

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Abstract

Background: Maternal triglycerides are increasingly recognised as important predictors of infant growth and fat mass. The variability of triglyceride patterns during the day and their relationship to dietary intake in women in late pregnancy have not been explored. This prospective cohort study aimed to examine the utility of monitoring capillary triglycerides in women in late pregnancy. Methods: Twenty-nine women (22 with gestational diabetes (GDM) and 7 without) measured capillary glucose and triglycerides using standard meters at home for four days. On two of those days, they consumed one of two standard isocaloric breakfast meals: a high-fat/low-carbohydrate meal (66% fat) or low fat/high carbohydrate meal (10% fat). Following the standard meals, glucose and triglyceride levels were monitored. Results: Median capillary triglycerides were highly variable between women but did not differ between GDM and normoglycaemic women. There was variability in capillary triglycerides over four days of home monitoring and a difference in incremental area under the curve for capillary triglycerides and glucose between the two standard meals. The high-fat standard meal lowered the incremental area under the curve for capillary glucose (p < 0.0001). Fasting (rho 0.66, p = 0.0002) and postpradial capillary triglycerides measured at home correlated with venous triglyceride levels. Conclusions: The lack of differences in response to dietary fat intake and the correlation between capillary and venous triglycerides suggest that monitoring of capillary triglycerides before and after meals in pregnancy is unlikely to be useful in the routine clinical practice management of women with gestational diabetes mellitus.

Highlights

Maternal metabolism is anabolic with an increase in maternal fat stores; in late pregnancy, maternal metabolism is catabolic, with increased insulin resistance and peripheral adipose tissue lipolysis resulting in increased maternal lipoprotein concentrations and increased lipoprotein triglyceride content [1]
In clinical practice managing women with diabetes in pregnancy, we focus on glucose and weight control, but there is evidence that elevated maternal triglycerides are associated with increased fetal growth; increased large for gestational age infants; and other adverse pregnancy outcomes such as preeclampsia and preterm delivery [1]
The aims of the current study were firstly to evaluate the variability of triglyceride levels across four days in women with and without gestational diabetes (GDM) in late pregnancy; secondly, to examine the postprandial capillary triglyceride and glucose response to two pragmatic standard test meals at home; and thirdly, to evaluate the practical use of the triglyceride meter in a larger cohort

Summary

Introduction

In clinical practice managing women with diabetes in pregnancy, we focus on glucose and weight control, but there is evidence that elevated maternal triglycerides are associated with increased fetal growth; increased large for gestational age infants; and other adverse pregnancy outcomes such as preeclampsia and preterm delivery [1]. Methods: Twenty-nine women (22 with gestational diabetes (GDM) and 7 without) measured capillary glucose and triglycerides using standard meters at home for four days. On two of those days, they consumed one of two standard isocaloric breakfast meals: a high-fat/lowcarbohydrate meal (66% fat) or low fat/high carbohydrate meal (10% fat). Results: Median capillary triglycerides were highly variable between women but did not differ between GDM and normoglycaemic women

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