- Pregestational biomarkers were linked to HDP risk: Several lipid, glucose-related, and inflammatory markers measured years before pregnancy were associated with increased odds of HDP in first pregnancies.
- Lipid markers showed the strongest and most consistent signals: Higher apolipoprotein B, LDL-C, total cholesterol, triglycerides, and ApoB/ApoA1 ratio were all associated with increased HDP risk, with ApoB showing one of the largest effect sizes.
- Risk extended below clinical thresholds: For markers such as triglycerides, total cholesterol, and LDL-C, increased risk was observed even at subclinical levels, suggesting current diagnostic cutoffs may not fully capture risk.
- Glucose findings were mixed: Diabetes was associated with nearly doubled odds of HDP, but prediabetes was not, and fasting glucose showed a nonlinear association across quartiles.
- Associations were largely linear for lipids: Modeling suggested approximately 20% higher odds of HDP per unit increase in several lipid measures, supporting a graded risk relationship rather than a strict threshold effect.
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