Evidence map›Paper›PMID 42046136›Full record

ArticleLipids in health and disease2026

Atherogenic index of plasma in early pregnancy: associations with gestational diabetes mellitus and preeclampsia and its mediating role.

Ning Zhang, Biying Wu, Jiangxia Li, Xiaoqin Wang, Rui Zhang, Jun Liu, Min Yang

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In one paragraph

Article in Lipids in health and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ning Zhang *Division of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Heqing Road 801, Minhang District, Shanghai, 200240, PR China.
Biying Wu *Department of Clinical Laboratory, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
Jiangxia Li *Central Laboratory, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
Xiaoqin Wang *Department of Obstetrics and Gynecology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Rui ZhangDivision of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Heqing Road 801, Minhang District, Shanghai, 200240, PR China.
Jun LiuDivision of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Heqing Road 801, Minhang District, Shanghai, 200240, PR China. liujun@5thhospital.com.
Min YangDivision of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Heqing Road 801, Minhang District, Shanghai, 200240, PR China. yangmin@5thhospital.com.

Funding

Medical Key Faculty Foundation of Shanghai 2024ZDXK0016Research Project of the Minhang District Health Commission 2024MW03Shanghai Natural Science Foundation 25ZR1402433
6 · The paper itself

Abstract

backgroundGestational diabetes mellitus (GDM) and preeclampsia (PE) are severe complications that significantly impact maternal and fetal well-being. Although their clinical association is well-established, the role of dyslipidemia remains unclear. The objective of this investigation was to characterize a readily available lipid indicator that functions as both an early predictor and a mediator of the link between GDM and PE, thereby supporting timely clinical intervention.

methodsA total of 1858 singleton pregnant women recruited from Eastern and Western China were included in this study. Fasting serum lipid profiles were collected during the first trimester (between the 10th and 14th weeks). Lasso regression and the Boruta algorithm were used to identify an optimized lipid-derived predictor for PE. Additionally, association and mediation modeling were implemented to evaluate the contribution of the selected lipid marker to the GDM-PE association.

resultsThe mean age of all participants was 30 (27, 33) years. The atherogenic index of plasma (AIP), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were the only lipid-related variables identified at the intersection of Lasso and Boruta analyses as candidate predictors for PE. In the GDM with PE group, AIP was significantly higher than in other subgroups, whereas TC and HDL-C were not. A high first-trimester AIP emerged as an independent risk factor for both GDM (adjusted odds ratio [aOR]: 1.74; 95% confidence interval [CI]: 1.33 to 2.27, P < 0.001) and PE (aOR: 2.38; 95% CI: 1.10 to 5.15, P = 0.028). Restricted cubic splines (RCS) analysis revealed a significant nonlinear association between AIP and the risk of GDM, and a linear association with PE. Crucially, mediation analysis demonstrated that AIP significantly mediated the association between GDM and PE, accounting for 31.45% of the total effect (P = 0.012), a proportion exceeding that of other lipid parameters such as triglyceride (TG) (29.58%).

conclusionsThese results demonstrate that early-pregnancy AIP predicts a greater susceptibility to both GDM and PE, while functioning as a critical mediator of their pathological interrelationship. These observations highlight AIP as a highly accessible and cost-effective indicator for stratifying PE risk, offering a practical strategy to mitigate severe obstetric complications and enhance global maternal health outcomes.

Indexed as

AtherosclerosisDiabetes, GestationalPre-EclampsiaAdultBiomarkersCholesterolCholesterol, HDLFemaleHumansLipidsPregnancyPregnancy Trimester, FirstRisk FactorsTriglyceridesBiomarkersCholesterolCholesterol, HDLLipidsTriglyceridesAtherogenic index of plasmaDiabetesGestationalMediation analysisPre-eclampsia

Identifiers

PMID42046136
PMCPMC13251104

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.