Correlation of lipoprotein-associated phospholipase A2 and abnormal glucose metabolism in postpartum women with previous gestational diabetes mellitus

Abstract

Objective To investigate the relationship between lipoprotein-associated phospholipase (Lp-PLA2) and postpartum abnormal glucose metabolism in patients with gestational diabetes mellitus(GDM). Methods All of 190 women with GDM and 261 healthy pregnant women who delivered in the Department of Obstetrics in Guangdong Obstetrics and Gynecology Hospital were recruited from January 2009 to August 2012. Laboratory tests included serum activity of Lp-PLA2, blood glucose, serum lipids, etc. The follow-up study(including oral glucose tolerance test(OGTT) and glycated hemoglobin A1c(HbA1c))was performed from November 2012 to April 2013. The selected cases consisted of 172 women with GDM and 249 healthy women as control group. Results (1)Postpartum abnormal glucose metabolism in GDM and the normal control group: type 2 diabetes mellitus(T2DM)(4.65%(8/172) vs 0%(0/249)), Pre-DM (39.53%(68/ 172) vs 12.45% (31/249)), the differences were statistically significant (P<0.05). (2)There were significant differences in variables between GDM and the normal control group:postpartum fasting blood glucose((4.5±0.7) vs (4.2±0.3) mmol/L, t=5.6, P<0.01), fasting insulin((9.7±4.9) vs (8.7±4.2) mmol/L, t=2.3, P<0.05), HOMA-IR(2.0±1.3 vs 1.7±1.1, t=2.6, P<0.05). (3) Lp-PLA2 activity: (33±11) vs (24±8) nmol·min-1·ml-1. (4) Lp-PLA2 was the risk factor of postpartum abnormal glucose metabolism (P=0.001). Receiver operating characteristic curve(ROC) analysis showed that Lp-PLA2 = 27.96 nmol.min-1.ml-1 was a demarcation point to diagnose postpartum abnormal glucose metabolism. The sensitivity and specificity are 71.3% and 82.1%, respectively. Conclusions Women with GDM have a higher risk of postpartum abnormal glucose metabolism. Lp-PLA2 is positively correlated with abnormal glucose metabolism in women with previous GDM. Key words: Diabetes mellitus, type 2; Diabetes, gestational; Abnormal glucose metabolism; Lipoprotein-associated phospholipase A2