The mediating role of inflammation-related indicators in the association of remnant cholesterol with gestational diabetes mellitus

PMCID: PMC12178596

PMID: 40537057

DOI: 10.7189/jogh.15.04172

Journal: Journal of global health

Publication Date: 2025-6-20

Authors: Lin L, Lin J, Yan J, Wang X

Key Points

• Higher RC levels in early pregnancy are independently associated with increased GDM risk
• Per unit increase in RC level corresponds to a 24% increased risk of GDM (RR = 1.24, 95% CI = 1.15–1.33)
• RC monitoring may provide an additional screening tool for early GDM risk assessment beyond traditional lipid markers

Summary

This prospective cohort study of 13,446 pregnant women investigated the relationship between remnant cholesterol (RC) levels in the first trimester and the risk of gestational diabetes mellitus (GDM). The researchers found a significant linear correlation between increasing RC levels and GDM risk, with the overall GDM incidence rising from 18.9% in the lowest RC quartile to 25.7% in the highest quartile.

The study revealed that higher RC levels were associated with increased GDM risk, even when traditional lipid markers remained within normal ranges. Notably, inflammation-related indicators like leukocytes and neutrophils partially mediated this association, suggesting potential underlying mechanisms involving inflammatory responses and insulin resistance. The findings persist across various subgroups, indicating the robust nature of RC as a potential early predictor of GDM risk.