Renal Research Group, Institute of Medicine, University of Bergen, Bergen, Norway.
Am J Obstet Gynecol. 2013 Dec;209(6):569.e1-569.e10. doi: 10.1016/j.ajog.2013.07.024. Epub 2013 Jul 27.
Recent studies have shown that women with a history of preeclampsia have an increased risk of cardiovascular disease. The present study investigated cardiovascular risk factors 10 years after preeclampsia in previously healthy women.
Based on data from the Medical Birth Registry in Norway, we selected 182 women with and 180 women without preeclampsia in their first pregnancy 9-11 years earlier, excluding women with cardiovascular or renal disease before pregnancy. Flow-mediated dilation of the brachial artery (FMD) and intima-media thickness (IMT) of the carotid artery were measured and blood samples were drawn. Blood samples were analyzed for cardiovascular risk markers and for circulating markers of endothelial function.
A total of 89 women with previous preeclampsia and 69 women without preeclampsia participated, an overall attendance rate of 44%. FMD and IMT were similar between groups. Women with previous preeclampsia more often had urate and soluble fms-like tyrosine kinase values above the 75th percentile (odds ratio [OR], 2.4; P = .03, and OR, 2.4; P = .04, respectively) and high-density lipoprotein cholesterol values below the 25th percentile (OR, 2.3; P = .04). Women with preeclampsia with low birthweight offspring were associated with asymmetric dimethylarginine, L-arginine, and homoarginine above the 75th percentile, whereas the women with preeclampsia with normal-weight offspring were associated with urate and soluble fms-like tyrosine kinase above the 75th percentile.
Preeclampsia was not associated with impaired FMD or increased IMT 10 years after pregnancy in previously healthy women, but preeclampsia was associated with changes in circulating markers that might represent early endothelial dysfunction.
最近的研究表明，有子痫前期病史的女性患心血管疾病的风险增加。本研究调查了 10 年前首次妊娠时无子痫前期的健康女性的心血管危险因素。
基于挪威医学出生登记处的数据，我们选择了 182 名首次妊娠时患有子痫前期的女性和 180 名无子痫前期的女性，排除了妊娠前患有心血管或肾脏疾病的女性。测量了肱动脉血流介导的扩张（FMD）和颈动脉内-中膜厚度（IMT），并抽取了血样。对血样进行了心血管风险标志物和内皮功能循环标志物的分析。
共有 89 名有既往子痫前期的女性和 69 名无子痫前期的女性参加了研究，总体参与率为 44%。两组间 FMD 和 IMT 无差异。有既往子痫前期的女性尿酸和可溶性 Fms 样酪氨酸激酶值高于第 75 百分位数的比例更高（比值比 [OR]，2.4；P =.03，和 OR，2.4；P =.04），高密度脂蛋白胆固醇值低于第 25 百分位数的比例更高（OR，2.3；P =.04）。出生体重较轻的子痫前期女性与不对称二甲基精氨酸、L-精氨酸和同型精氨酸高于第 75 百分位数有关，而出生体重正常的子痫前期女性与尿酸和可溶性 Fms 样酪氨酸激酶高于第 75 百分位数有关。
子痫前期与妊娠 10 年后健康女性的 FMD 受损或 IMT 增加无关，但子痫前期与循环标志物的变化有关，这些变化可能代表早期内皮功能障碍。
