Department of Gynecology & Obstetrics, Peking University Third Hospital, Beijing 100191, China.
Chin Med J (Engl). 2011 Mar;124(5):775-9.
Women with a history of preeclampsia have twice the risk of cardiovascular diseases, and there is a graded relationship between the severity of preeclampsia and the risk of cardiac disease. Moreover, metabolic scores are associated with developing preeclampsia. However, since there are no diagnostic criteria for metabolic syndrome during pregnancy and pregnant women undergo metabolic changes, it is difficult to elucidate the relationship between preeclampsia and metabolic syndrome. We carried out a cross-sectional study to investigate the relationship between metabolic syndrome and preeclampsia among women with a history of severe preeclampsia shortly after an indexed pregnancy.
We recruited 62 women with a history of severe preeclampsia 1 to 3 years after an indexed pregnancy. Blood pressure and body compositional indices were recorded. Fasting blood samples were tested for glucose, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, triglycerides, and insulin. A questionnaire was used to collect demographic data including pre-pregnancy weight and family history of diseases associated with cardiovascular diseases. Criteria for metabolic syndrome were defined by the National Cholesterol Education Program, Adult Treatment Panel III 2001 (NCEP III) and International Diabetes Federation 2005 (IDF). Data were analyzed by the a2 test and multivariate Logistic regression.
According to NCEP III and IDF standards, 17 (27%) and 24 (39%) women, respectively, were identified as having metabolic syndrome. Being overweight pre-pregnancy and currently overweight were risk factors, and currently overweight was an independent risk factor. A combination of blood pressure and waist circumference was predictive of metabolic syndrome with a sensitivity of 91.67% and specificity of 94.74%.
An unfavorable metabolic constitution in women may lead to metabolic syndrome, preeclampsia, and long-term cardiovascular disease. In women with severe preeclampsia, therapeutic interventions should include weight-control shortly after pregnancy, especially among women who were previously overweight.
患有子痫前期病史的女性发生心血管疾病的风险增加一倍，子痫前期的严重程度与心脏病风险呈分级关系。此外，代谢评分与子痫前期的发生有关。然而，由于妊娠期间没有代谢综合征的诊断标准，并且孕妇会发生代谢变化，因此很难阐明子痫前期与代谢综合征之间的关系。我们进行了一项横断面研究，以调查在索引妊娠后不久患有重度子痫前期病史的女性中代谢综合征与子痫前期之间的关系。
我们招募了 62 名在索引妊娠后 1 至 3 年内患有重度子痫前期病史的女性。记录血压和身体成分指数。采集空腹血样，检测血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯和胰岛素。使用问卷收集人口统计学数据，包括孕前体重和与心血管疾病相关的家族病史。代谢综合征的标准按照国家胆固醇教育计划、成人治疗专家组 III 2001 年（NCEP III）和国际糖尿病联盟 2005 年（IDF）的标准进行定义。数据通过 a2 检验和多变量 Logistic 回归进行分析。
根据 NCEP III 和 IDF 标准，分别有 17（27%）和 24（39%）名女性被诊断为患有代谢综合征。孕前超重和目前超重是风险因素，目前超重是独立的风险因素。血压和腰围的组合对代谢综合征具有较高的预测价值，其敏感性为 91.67%，特异性为 94.74%。
女性不良的代谢体质可能导致代谢综合征、子痫前期和长期心血管疾病。在患有重度子痫前期的女性中，治疗干预措施应包括产后短期内的体重控制，特别是针对那些孕前超重的女性。
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