{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:22:53Z","timestamp":1792700573574,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women with gestational diabetes mellitus (GDM) are at high risk of developing hypertriglyceridemia (HTG) in late pregnancy, a condition associated with adverse maternal and neonatal outcomes. Early identification of high-risk individuals at GDM diagnosis is crucial for timely intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and internally validate a clinical risk prediction model for estimating the individualized risk of late-pregnancy HTG in women at the time of GDM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 587 women with GDM. Predictor variables, available at or before GDM diagnosis (24\u201328 weeks), included demographic characteristics, glycemic markers from the 75g oral glucose tolerance test (OGTT), and first-trimester lipid profiles. The outcome was late-pregnancy HTG, defined as a triglyceride level \u2265 2.3 mmol\/L. The dataset was randomly split into a training set (70%) and a held-out internal test set (30%) for secondary performance assessment, whereas bootstrap resampling of the full analytic cohort was used as the primary internal validation strategy to quantify optimism. Variable selection was performed using LASSO logistic regression with 10-fold cross-validation in the training set, followed by standard multivariable logistic regression. Model performance was assessed using discrimination, calibration-in-the-large, calibration slope, Brier score, scaled Brier score, and decision curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of late-pregnancy HTG was 32.7% (192\/587). The final model incorporated five predictors: pre-gravid BMI, fasting plasma glucose (FPG) at diagnosis, 1-hour post-load glucose (1hPG) at diagnosis, first-trimester triglycerides (TG), and first-trimester high-density lipoprotein cholesterol (HDL-C). The model demonstrated good discrimination in the held-out internal test set, with an AUC of 0.816 (95% CI: 0.754\u20130.878), calibration-in-the-large of \u22120.03, calibration slope of 0.94, Brier score of 0.151, and scaled Brier score of 0.301. Bootstrap internal validation of the full cohort showed limited optimism, with an optimism-corrected AUC of 0.805, calibration-in-the-large of \u22120.02, calibration slope of 0.91, Brier score of 0.158, and scaled Brier score of 0.269. Decision curve analysis supported clinical utility across clinically relevant thresholds, and the full five-variable model provided modestly higher net benefit than the four-variable model excluding first-trimester TG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study developed and internally validated a prediction model for late-pregnancy HTG in women with GDM using five routinely available clinical parameters. The model shows promising performance for individualized risk stratification at GDM diagnosis, potentially facilitating targeted monitoring and management. External validation in independent multicenter cohorts is required before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1845573","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:45:58Z","timestamp":1782452758000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Early prediction of late-pregnancy hypertriglyceridemia in women with gestational diabetes: development and internal validation of a clinical risk model"],"prefix":"10.3389","volume":"17","author":[{"given":"Yaping","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Affiliated Kunshan Hospital of Jiangsu University","place":["Kunshan, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Affiliated Kunshan Hospital of Jiangsu University","place":["Kunshan, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Affiliated Kunshan Hospital of Jiangsu University","place":["Kunshan, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0719","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"Metzger","year":"2010","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19113342","article-title":"The pathophysiology of gestational diabetes mellitus","volume":"19","author":"Plows","year":"2018","journal-title":"Int J Mol Sci"},{"key":"B3","article-title":"Dyslipidemia in gestational diabetes mellitus","volume":"19","author":"Echeverria","year":"2021","journal-title":"Curr Vasc Pharmacol"},{"key":"B4","first-page":"22","article-title":"Dyslipidemia during pregnancy and the risk of adverse pregnancy outcomes: a systematic review and meta-analysis","volume":"20","author":"Shang","year":"2021","journal-title":"Lipids Health Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1016\/j.amjmed.2021.12.006","article-title":"Prevention and management of hypertriglyceridemia-induced acute pancreatitis during pregnancy: a systematic review","volume":"135","author":"Gupta","year":"2022","journal-title":"Am J Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1186\/s12884-022-05219-4","article-title":"Risk prediction models of gestational diabetes mellitus before 16 gestational weeks","volume":"22","author":"Wei","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102888","article-title":"Maternal lipid profile during pregnancy in gestational diabetes mellitus and a possible association with perinatal outcomes\u2014a retrospective study","volume":"11","author":"Costa","year":"2022","journal-title":"J Clin Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12944-021-01597-4","article-title":"The association between maternal lipid profile and macrosomia in pregnant women with gestational diabetes mellitus: a retrospective cohort study","volume":"20","author":"Shang","year":"2021","journal-title":"Lipids Health Dis"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13261","article-title":"Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis","volume":"122","author":"Ryckman","year":"2015","journal-title":"BJOG"},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-018-1248-7","article-title":"The effect of a lifestyle intervention in obese pregnant women on gestational metabolic profiles: findings from the UK Pregnancies Better Eating and Activity Trial (UPBEAT) randomised controlled trial","volume":"17","author":"Mills","year":"2019","journal-title":"BMC Med"},{"key":"B11","volume-title":"Obesity: preventing and managing the global epidemic. 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