Are triglyceride/glucose index and triglyceride levels in pregnancy associated with birth weight of infants of mothers with gestational diabetes

• Grant number: 22/03312-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): August 01, 2022
• Effective date (End): July 31, 2023
• Field of knowledge: Biological Sciences - Biochemistry - Metabolism and Bioenergetics
• Principal Investigator: Bianca de Almeida Pititto
• Grantee: Alexandre Petinati Pereira
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Aims/Introduction: Pregnant women with gestational diabetes mellitus (GDM) have been reported to have higher chances of having babies large for gestacional age or macrosomia with short e long-term adverse outcomes. It is also described that women with GDM had higher serum triglycerides (TG) levels than pregnant women without GDM. TG-related calculation-based indices, such as the triglyceride/glucose (TyG) index (= log[(TG mg/dL x blood glucose mg/dL)/2]), have been associated with insulin resistance and cardiometabolic outcomes in non-pregnant adults. The dosage of TG and the development of correlated indices have received attention from the scientific community because they are markers or predictors of unfavorable health outcomes, easy to access and use in clinical practice. However, there is a lack of studies showing a correlation between TG levels and these indices with maternal-fetal outcomes, especially in a population at higher risk of maternal-fetal complications as women with GDM. In this context, the aim of the current study is to evaluate the association between infant birth weight (and the occurrence of GIG babies) and TG and TyG levels during pregnancy in women with GDM. Methods: The study design is a retrospective cohort that includes data collected during pregnancy of 1064 women from the Diabetes and Pregnancy Outpatient Service of Universidade Federal de São Paulo (UNIFESP), regarding high-risk prenatal follow-up from January 2008 to November 2021. Therefore, the research has a preexisting database, with: pre-pregnancy weight, weight gain during pregnancy, form of treatment for GDM, presence of previous comorbities and during pregnancy, type of delivery, amog others. In order to ensure anonymization and data confidentiality, the column of names will be excluded to break the association between the patient and her data, which will be identified by the enumeration of the rows in the excel spreadsheet. Statistical analysis will evaluate the association between exposure variables (TG level in the second or third trimester of these mothers with GDM and the TyG index) and outcome (birth weight and LGA). Linear (continuous dependent variable) or logistic regression (explanatory dependent variable) will be employed to assess the association between the exposure and outcome variable as needed. The expectation is that this study will identify a predictor of the outcome occurrence of LGA, for the development of prevention strategies against this neonatal complication that increases risk of preeclampsia, neonatal hypoglycemia, preterm delivery, among others. Our hypothesis is that TG levels and TyG index measured during gestation of women with GDM are directly associated with higher occurrence of GIG newborns.