After adjusting for covariates, including age, parity, pre-pregnancy BMI, AST, GGT, ALT, HOMA-IR, and adiponectin, the findings consistently indicated an association between the RC/HDL-C ratio and GDM incidence (OR = 32.28, 95% CI: 2.08–500.67). The gene discussed is GPT; the disease is gestational diabetes.