Kärkkäinen Henna, Saarelainen Heli, Valtonen Pirjo, Laitinen Tiina, Raitakari Olli T, Juonala Markus, Kähönen Mika, Hutri-Kähönen Nina, Heinonen Seppo, Laitinen Tomi
Department of Obst/Gyn, Kuopio University Hospital, University of Eastern Finland, P,O,B, 100FIN-70029 Kuopio, Finland.
BMC Pregnancy Childbirth. 2014 Mar 6;14:98. doi: 10.1186/1471-2393-14-98.
The aims were to evaluate the effect of pregnancy on carotid artery elasticity and determine the associations between maternal lipids, endothelial function and arterial elasticity during pregnancy.
We examined 99 pregnant and 99 matched non-pregnant control women as part of a population-based prospective cohort study. Carotid artery elasticity indexes; carotid artery distensibility (CAD), Young's elastic modulus (YEM) and stiffness index (SI) as well as brachial artery flow-mediated dilation (FMD) were assessed using ultrasound; serum lipid levels were also determined.
SI was 57% and YEM 75% higher and CAD 36% lower in the third trimester group than the corresponding values in the first trimester group. Serum cholesterol and triglyceride levels were significantly higher in women at the end of the pregnancy than at the beginning of pregnancy (P < 0.001) and in controls (P < 0.001). In multivariate analysis, gestational age was the only independent correlate of arterial elasticity in pregnant women. In controls, age (P ≤ 0.001) and common carotid diameter (P = 0.001-0.029) were associated with SI, YEM and CAD.
The present study revealed that carotid artery elasticity declined towards the end of the pregnancy; this neither is straight correlating with maternal hyperlipidemia or the diameter of the carotid artery nor is it associated with changes in endothelial function.
本研究旨在评估妊娠对颈动脉弹性的影响，并确定孕期母体血脂、内皮功能与动脉弹性之间的关联。
作为一项基于人群的前瞻性队列研究的一部分，我们对99名孕妇和99名匹配的非孕妇对照进行了检查。使用超声评估颈动脉弹性指数，包括颈动脉扩张性（CAD）、杨氏弹性模量（YEM）和硬度指数（SI），以及肱动脉血流介导的扩张（FMD）；同时测定血清脂质水平。
与孕早期组相应值相比，孕晚期组的SI高57%，YEM高75%，CAD低36%。孕妇妊娠末期的血清胆固醇和甘油三酯水平显著高于妊娠初期（P < 0.001）和对照组（P < 0.001）。多因素分析显示，孕周是孕妇动脉弹性的唯一独立相关因素。在对照组中，年龄（P≤0.001）和颈总动脉直径（P = 0.001 - 0.029）与SI、YEM和CAD相关。
本研究表明，妊娠末期颈动脉弹性下降；这既与母体高脂血症或颈动脉直径无直接关联，也与内皮功能变化无关。
