复发性子痫前期和曾患有子痫前期但下次妊娠正常的女性在孕早期的血脂谱变化。
Early-pregnancy changes in maternal lipid profile in women with recurrent preeclampsia and previously preeclamptic women with normal next pregnancy.
机构信息
Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
出版信息
Reprod Sci. 2011 Oct;18(10):998-1004. doi: 10.1177/1933719111401665.
OBJECTIVE
To evaluate early-pregnancy changes in lipid profile in recurrent preeclampsia.
METHODS
In this retrospective observational study, blood samples were obtained from 41 normotensive women with a history of early-onset preeclampsia preconceptionally and at 12 and 16 weeks in the next pregnancy. We assessed triglycerides (TGs), total cholesterol (TC), and high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively). We analyzed differences in longitudinal patterns between normal and recurrent preeclamptic next pregnancy using mixed-design repeated measurements analysis of covariance (ANCOVA).
RESULTS
Eleven (28%) women developed recurrent preeclampsia. Eighteen (45%) women had a normal pregnancy. In normal pregnancy, LDL-C declines transiently in the first trimester (P < .01). In women who develop recurrent preeclampsia later on this decline was absent. Moreover, from 12 weeks onward the elevating levels of HDL-C stagnates in women who subsequently develop recurrent preeclampsia (P = .02).
CONCLUSION
These observations point to an abnormal early adaptation of lipid metabolism to pregnancy preceding clinical manifestation of preeclampsia.
目的
评估复发性子痫前期孕妇妊娠早期血脂谱的变化。
方法
本回顾性观察性研究共纳入 41 例有早发型子痫前期病史且无高血压的正常孕妇，于孕前及下次妊娠 12 周和 16 周采集血样。我们评估了甘油三酯（TGs）、总胆固醇（TC）以及高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的水平。我们采用混合设计重复测量方差分析（ANCOVA）分析了正常和复发性子痫前期孕妇的纵向变化模式。
结果
11 例（28%）孕妇发生了复发性子痫前期。18 例（45%）孕妇为正常妊娠。在正常妊娠中，LDL-C 在孕早期会短暂下降（P<0.01）。而在随后发生复发性子痫前期的孕妇中，这种下降则不存在。此外，从 12 周开始，随后发生复发性子痫前期的孕妇的 HDL-C 水平升高趋于停滞（P=0.02）。
结论
这些观察结果表明，在子痫前期的临床表现出现之前，脂代谢的早期适应性异常与复发性子痫前期有关。
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