In this prospective study exploring the correlation of lipid profiles and lipid ratios with subsequent GDM risk in early to mid-pregnancy, we found that TG, ApoA1, ApoB, LDL-c, triglyceride glucose index, TG/HDL-c, and TC/HDL-c were positively correlated with the risk of GDM in early gestation, whereas HDL-c was negatively associated with GDM risk. The gene discussed is APOB; the disease is gestational diabetes.