{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T23:14:55Z","timestamp":1782429295406,"version":"3.54.5"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973043"],"award-info":[{"award-number":["81973043"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173511"],"award-info":[{"award-number":["82173511"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81773426"],"award-info":[{"award-number":["81773426"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173513"],"award-info":[{"award-number":["82173513"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973043"],"award-info":[{"award-number":["81973043"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173511"],"award-info":[{"award-number":["82173511"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81773426"],"award-info":[{"award-number":["81773426"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173513"],"award-info":[{"award-number":["82173513"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This study aims to determine the association of pregnancy cholesterol metabolism markers with gestational diabetes mellitus (GDM) risk. We performed a nested case\u2013control study in the Tongji Birth Cohort. GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24\u201328 gestational weeks. Nine cholesterol metabolism markers were detected using gas chromatography-mass spectrometry. Conditional logistic regression models were conducted. A total of 444 pregnant women were matched in a 1:2 ratio. The cholestanolTC and \u03b2-sitosterolTC in cholesterol absorption markers presented negative associations with the risks of GDM (adjusted OR: 0.77, 95% CI: 0.61\u20130.96; adjusted OR: 0.80, 95% CI: 0.64\u20131.00). The desmosterolTC in cholesterol synthesis markers were positively associated with the risks of GDM (adjusted OR: 1.25, 95% CI: 1.00\u20131.56), similar in the ratios of cholesterol synthesis to absorption markers. After adjustment for insulin or HOMA-IR, these effects were reduced. In conclusion, higher cholesterol synthesis and lower cholesterol absorption marker levels in the first pregnancy are associated with a higher risk of GDM, and insulin resistance may play a vital role in this association.<\/jats:p>","DOI":"10.3390\/nu15173809","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T11:41:18Z","timestamp":1693482078000},"page":"3809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pregnancy Cholesterol Metabolism Markers and the Risk of Gestational Diabetes Mellitus: A Nested Case-Control Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Yan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"},{"name":"Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"},{"name":"School of Public Health, Guangzhou Medical University, Guangzhou 511436, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningning","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junan","family":"Yan","sequence":"additional","affiliation":[{"name":"Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggang","family":"Li","sequence":"additional","affiliation":[{"name":"Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Luo","sequence":"additional","affiliation":[{"name":"Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Wuhan 430014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6787-4437","authenticated-orcid":false,"given":"Xuefeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"109050","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group\u2019s Criteria","volume":"183","author":"Wang","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_2","first-page":"CD010443","article-title":"Combined Diet and Exercise Interventions for Preventing Gestational Diabetes Mellitus","volume":"2017","author":"Shepherd","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sadiya, A., Jakapure, V., Shaar, G., Adnan, R., and Tesfa, Y. (2022). Lifestyle Intervention in Early Pregnancy Can Prevent Gestational Diabetes in High-Risk Pregnant Women in the UAE: A Randomized Controlled Trial. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-04972-w"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/S0022-2275(20)35728-X","article-title":"Role of Liver in the Maintenance of Cholesterol and Low Density Lipoprotein Homeostasis in Different Animal Species, Including Humans","volume":"34","author":"Dietschy","year":"1993","journal-title":"J. Lipid Res."},{"key":"ref_5","unstructured":"US Department of Health and Human Services and US Department of Agriculture (2015). 2015\u20132020 Dietary Guidelines for Americans, US Department of Health and Human Services and US Department of Agriculture. [8th ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.clnu.2019.06.016","article-title":"Pregnancy Dietary Cholesterol Intake, Major Dietary Cholesterol Sources, and the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study","volume":"39","author":"Wu","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_7","first-page":"107","article-title":"Dietary Cholesterol Intake and Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies","volume":"41","author":"Gao","year":"2021","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.numecd.2011.05.005","article-title":"The Role of Serum Non-Cholesterol Sterols as Surrogate Markers of Absolute Cholesterol Synthesis and Absorption","volume":"21","author":"Miettinen","year":"2011","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.atherosclerosis.2007.08.003","article-title":"The Validity of Serum Squalene and Non-Cholesterol Sterols as Surrogate Markers of Cholesterol Synthesis and Absorption in Type 2 Diabetes","volume":"197","author":"Simonen","year":"2008","journal-title":"Atherosclerosis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.2337\/diacare.25.9.1511","article-title":"Diabetes Contributes to Cholesterol Metabolism Regardless of Obesity","volume":"25","author":"Simonen","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Stellaard, F. (2022). From Dietary Cholesterol to Blood Cholesterol, Physiological Lipid Fluxes, and Cholesterol Homeostasis. Nutrients, 14.","DOI":"10.3390\/nu14081643"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.atherosclerosis.2010.01.003","article-title":"Relationship between Cholesterol Synthesis and Intestinal Absorption Is Associated with Cardiovascular Risk","volume":"210","author":"Laufs","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.chemphyslip.2011.03.008","article-title":"Markers of Enhanced Cholesterol Absorption Are a Strong Predictor for Cardiovascular Diseases in Patients without Diabetes Mellitus","volume":"164","author":"Vanmierlo","year":"2011","journal-title":"Chem. Phys. Lipids"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.numecd.2015.03.012","article-title":"Markers of Cholesterol Metabolism as Biomarkers in Predicting Diabetes in the Finnish Diabetes Prevention Study","volume":"25","author":"Lindstrom","year":"2015","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cederberg, H., Gylling, H., Miettinen, T.A., Paananen, J., Vangipurapu, J., Pihlajamaki, J., Kuulasmaa, T., Stancakova, A., Smith, U., and Kuusisto, J. (2013). Non-Cholesterol Sterol Levels Predict Hyperglycemia and Conversion to Type 2 Diabetes in Finnish Men. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0067406"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1194\/jlr.P049510","article-title":"Elevated Serum Squalene and Cholesterol Synthesis Markers in Pregnant Obese Women with Gestational Diabetes Mellitus","volume":"55","author":"Miettinen","year":"2014","journal-title":"J. Lipid Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"676","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":"ref_18","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1194\/jlr.P006619","article-title":"Insulin Sensitivity Regulates Cholesterol Metabolism to a Greater Extent than Obesity: Lessons from the METSIM Study","volume":"51","author":"Gylling","year":"2010","journal-title":"J. Lipid Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1093\/ajcn\/72.1.82","article-title":"Introducing a New Component of the Metabolic Syndrome: Low Cholesterol Absorption","volume":"72","author":"Simonen","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.2337\/diabetes.53.9.2217","article-title":"Cholesterol Metabolism in Type 1 Diabetes","volume":"53","author":"Gylling","year":"2004","journal-title":"Diabetes"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"90","DOI":"10.2337\/diacare.20.1.90","article-title":"Cholesterol Absorption, Synthesis, and LDL Metabolism in NIDDM","volume":"20","author":"Gylling","year":"1997","journal-title":"Diabetes Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.phrs.2006.08.005","article-title":"Effect of Atorvastatin on Soluble CD14, CD40 Ligand, sE- and sP-Selectins and MCP-1 in Patients with Type 2 Diabetes Mellitus: Relationship to Cholesterol Turnover","volume":"54","author":"Blaha","year":"2006","journal-title":"Pharmacol. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1517\/14656566.2015.1057120","article-title":"Anagliptin Decreases Serum Lathosterol Level in Patients with Type 2 Diabetes: A Pilot Study","volume":"16","author":"Aoki","year":"2015","journal-title":"Expert Opin. Expert Opin. Pharmacother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.phrs.2004.07.007","article-title":"Effect of Atorvastatin on Non-Cholesterol Sterols in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease","volume":"51","author":"Smahelova","year":"2005","journal-title":"Pharmacol. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1194\/jlr.M300368-JLR200","article-title":"Insulin Resistance Is Associated with Increased Cholesterol Synthesis and Decreased Cholesterol Absorption in Normoglycemic Men","volume":"45","author":"Gylling","year":"2004","journal-title":"J. Lipid Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.atherosclerosis.2010.02.029","article-title":"Insulin Resistance Is Associated with Increased Cholesterol Synthesis, Decreased Cholesterol Absorption and Enhanced Lipid Response to Statin Therapy","volume":"211","author":"Hoenig","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1038\/oby.2002.46","article-title":"Body Weight Modulates Cholesterol Metabolism in Non-Insulin Dependent Type 2 Diabetics","volume":"10","author":"Simonen","year":"2002","journal-title":"Obes. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mce.2012.06.007","article-title":"Regulation of Cholesterol Homeostasis","volume":"368","author":"Verkade","year":"2013","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1017\/S0007114507811998","article-title":"Responses of Surrogate Markers of Cholesterol Absorption and Synthesis to Changes in Cholesterol Metabolism during Various Amounts of Fat and Cholesterol Feeding among Healthy Men","volume":"99","author":"Nissinen","year":"2008","journal-title":"Br. J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0021-9150(00)00404-4","article-title":"Cholesterol Absorption Efficiency and Sterol Metabolism in Obesity","volume":"153","author":"Miettinen","year":"2000","journal-title":"Atherosclerosis"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0022-2275(20)33370-8","article-title":"Percent Cholesterol Absorption in Normal Women and Men Quantified with Dual Stable Isotopic Tracers and Negative Ion Mass Spectrometry","volume":"40","author":"Bosner","year":"1999","journal-title":"J. Lipid Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1194\/jlr.M300522-JLR200","article-title":"Polymorphisms in the ABCG5 and ABCG8 Genes Associate with Cholesterol Absorption and Insulin Sensitivity","volume":"45","author":"Gylling","year":"2004","journal-title":"J. Lipid Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1172\/JCI0216001","article-title":"Overexpression of ABCG5 and ABCG8 Promotes Biliary Cholesterol Secretion and Reduces Fractional Absorption of Dietary Cholesterol","volume":"110","author":"Yu","year":"2002","journal-title":"J. Clin. Investig."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3809\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:43:31Z","timestamp":1760129011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,31]]},"references-count":33,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["nu15173809"],"URL":"https:\/\/doi.org\/10.3390\/nu15173809","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,31]]}}}