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This study aimed to investigate the correlation between serum LDL-C levels and the risk of GDM. A case\u2013control study was conducted. Glycolipid metabolic and oxidative stress indicators were measured in 696 women with GDM and 1048 healthy pregnant women. Serum LDL-C levels were significantly lower in the GDM group than in the control group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Subgroup analysis indicated that reduced LDL-C levels were associated with an increased risk of GDM after adjusting for differences in maternal age, pre-pregnancy body mass index (BMI), gestational age at sampling, fasting glucose and insulin levels, and homeostatic model assessment of insulin resistance (odds ratio [OR] 1.372, 95% confidence interval [CI] 1.050\u20131.794, <jats:italic>P<\/jats:italic>\u2009=\u20090.021 for medium-LDL-C subgroup; OR 1.672, 95% CI 1.219\u20132.294, <jats:italic>P<\/jats:italic>\u2009=\u20090.001 for low-LDL-C subgroup). The risk of GDM decreased by 17.6% per 1\u00a0mmol\/L increase in LDL-C level (OR 0.824, 95% CI 0.733\u20130.926, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). Furthermore, apolipoprotein (apo) A1 and high-density lipoprotein cholesterol (HDL-C) levels were lower, whereas pre-pregnancy and delivery BMI, triglyceride (TG)\/HDL-C ratios, and second-trimester fasting glucose levels were higher in the low-LDL-C GDM subgroup than those in the high- and\/or medium-LDL-C GDM subgroups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). ApoA1 and HDL-C levels were lower but TG\/HDL-C ratios were higher in the medium-LDL-C GDM subgroup than those in the high-LDL-C GDM subgroup (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). We concluded that reduced LDL-C levels were associated with an elevated risk of GDM in the study population. Low LDL-C levels correlated with increased BMI and unfavorable TG, HDL, and glucose metabolism.<\/jats:p>","DOI":"10.1038\/s41598-025-91258-8","type":"journal-article","created":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T03:02:31Z","timestamp":1740193351000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reduced low-density lipoprotein cholesterol levels are associated with increased risk of gestational diabetes mellitus in Chinese women"],"prefix":"10.1038","volume":"15","author":[{"given":"Shuai","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,22]]},"reference":[{"key":"91258_CR1","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1210\/endrev\/bnac003","volume":"43","author":"A Sweeting","year":"2022","unstructured":"Sweeting, A., Wong, J., Murphy, H. 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This study was approved by the Institutional Review Board of West China Second University Hospital of Sichuan University (2015-016 to X Liu and 2020-036 to P Fan).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"6435"}}