Higher levels of the atherogenic index of plasma before routine glucose testing were linked to more than double the risk of gestational diabetes, although varying thresholds mean it is not yet ready to replace standard screening.
A study in the International Journal of Gynaecology and Obstetrics suggests that a lipid-based marker measured early in pregnancy may help identify women at higher risk of gestational diabetes before routine glucose testing is usually carried out. In a prospective cohort from the Tongji Maternal and Child Health Cohort, researchers examined the atherogenic index of plasma, or AIP, at 11 to 20 weeks of gestation and found that higher values were associated with a greater chance of later developing gestational diabetes.
The study followed 2,068 women with singleton pregnancies and used fasting triglycerides and high-density lipoprotein cholesterol to calculate AIP before the usual 24- to 28-week oral glucose tolerance test. Gestational diabetes was diagnosed in 252 participants, or 12.3%. Women in the highest AIP quartile had more than twice the adjusted risk of gestational diabetes compared with those in the lowest quartile, and the relationship appeared to strengthen in step with rising AIP rather than showing a sharp threshold effect. The researchers reported that an AIP of 0.091 gave the best balance of sensitivity and specificity for prediction, although the resulting model was only moderately accurate on its own.
The findings add to a growing body of work linking AIP with glucose intolerance in pregnancy. A Korean cohort study indexed on PubMed found a similar positive association between higher AIP and gestational diabetes, though its proposed cut-off point was much higher than the threshold reported in the Tongji cohort. Another recent study also linked elevated first-trimester AIP with a higher risk of gestational diabetes and with worse glucose readings on oral glucose tolerance testing, suggesting that the marker may reflect broader metabolic stress rather than pregnancy-specific risk alone.
Some newer research goes further, pointing to possible implications beyond diagnosis. One PubMed-listed study reported that higher first-trimester AIP was associated not only with gestational diabetes but also with heavier birth weight, with fasting glucose explaining part of that relationship. Another two-centre cohort study found that AIP and cumulative AIP were associated with hypertensive disorders of pregnancy and neonatal intensive care admission among women with gestational diabetes. Taken together, the evidence suggests AIP could become a useful early warning sign, but the different thresholds reported across studies indicate that it is not yet a stand-alone screening tool.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
