Micronutrient and Lipid Profile in Gestational Diabetes: Zinc, Triglycerides, and Pharmacological Treatment Requirement

Vollständiger Abstract

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Objective: To characterize serum zinc and a broader micronutrient panel in gestational diabetes mellitus (GDM) versus normoglycemic controls, and to evaluate associations between serum zinc, pharmacological treatment requirement and triglyceride concentration within GDM.Material and Methods: In this observational study with a one-week prospective follow-up component, 100 women with GDM and 100 frequency-matched controls were studied at a tertiary center. A nine-analyte micronutrient panel was compared with Benjamini-Hochberg correction. Zinc was measured at diagnosis and treatment requirement determined one week later by a prespecified capillary glucose rule. Incremental value was tested by adding zinc to a baseline clinical model (age, body mass index, parity, three OGTT values, HbA1c).Results: Only zinc differed after correction (77.0 [71.0-80.4] vs. 86.3 [76.0-96.0] µg/dL; rank-biserial r = -0.47; q < .001), with serum zinc below 70 µg/dL more frequent in GDM (20% vs. 1%). Triglycerides were higher in GDM, whereas HDL-C and LDL-C did not differ. Diet-managed women had higher zinc than those treated pharmacologically (85.5 vs. 75.3 µg/dL). Adding zinc improved discrimination from an optimism-corrected AUC of 0.510 to 0.833 (DeLong p = .003). Zinc was inversely associated with triglycerides after adjustment for age and BMI (β = -2.65 mg/dL per µg/dL; p = .008).Conclusion: Lower serum zinc at diagnosis was associated with subsequent pharmacological treatment requirement and carried information beyond routine clinical variables, supporting its evaluation as a candidate prognostic marker rather than an established predictor. External validation is required before clinical use.