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孕期血脂水平与子痫前期和妊娠期糖尿病的关联:一项基于人群的研究。

Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study.

作者信息

Wiznitzer Arnon, Mayer Amit, Novack Victor, Sheiner Eyal, Gilutz Harel, Malhotra Atul, Novack Lena

机构信息

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.

出版信息

Am J Obstet Gynecol. 2009 Nov;201(5):482.e1-8. doi: 10.1016/j.ajog.2009.05.032. Epub 2009 Jul 24.

Abstract

OBJECTIVE

The study evaluates lipids profile changes during gestation in pregnancies with and without preeclampsia and/or gestational diabetes.

STUDY DESIGN

Lipid profiles were assessed between year prior and after pregnancy in 9911 women without cardiovascular comorbidities.

RESULTS

Lipid levels during gestation varied substantially with a nadir following conception and a peak at delivery. Compared to preconception levels total cholesterol levels increased from 164.4 mg/dL to 238.6 mg/dL and triglycerides (TGs) from 92.6 mg/dL to 238.4 mg/dL. The composite endpoint (gestational diabetes mellitus or preeclampsia) occurred in 1209 women (12.2%). Its prevalence increased with levels of TG-from 7.2% in the group with low TGs (<25th percentile adjusted for the gestational month) to 19.8% in the group with high TGs (>75th percentile), but was not associated with high-density lipoprotein levels. In multivariate analysis higher TGs levels, but not low high-density lipoprotein, were associated with the primary endpoint.

CONCLUSION

Lipid levels change substantially during gestation. Abnormal levels of TGs are associated with pregnancy complications.

摘要

目的

本研究评估了患有和未患有子痫前期和/或妊娠期糖尿病的孕妇在妊娠期间的血脂变化情况。

研究设计

对9911名无心血管合并症的女性在孕前一年和孕后进行了血脂评估。

结果

妊娠期间血脂水平变化很大,受孕后降至最低点,分娩时达到峰值。与孕前水平相比,总胆固醇水平从164.4毫克/分升升至238.6毫克/分升,甘油三酯(TGs)从92.6毫克/分升升至238.4毫克/分升。1209名女性(12.2%)出现了复合终点(妊娠期糖尿病或子痫前期)。其患病率随TG水平升高而增加——从TG水平低的组(低于根据妊娠月份调整后的第25百分位数)的7.2%增至TG水平高的组(高于第75百分位数)的19.8%,但与高密度脂蛋白水平无关。在多变量分析中,较高的TG水平而非低高密度脂蛋白水平与主要终点相关。

结论

妊娠期间血脂水平变化很大。TG水平异常与妊娠并发症相关。

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本文引用的文献

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N Engl J Med. 2008 May 8;358(19):1991-2002. doi: 10.1056/NEJMoa0707943.
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Manifestations of chronic disease during pregnancy.孕期慢性病的表现。
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