Wolak Talya, Shoham-Vardi Ilana, Sergienko Ruslan, Sheiner Eyal
a Hypertension Unit .
b Department of Public Health , and.
J Matern Fetal Neonatal Med. 2016 Mar;29(6):1021-4. doi: 10.3109/14767058.2015.1032238. Epub 2015 Sep 4.
The present study was aimed to determine whether high potassium level during pregnancy is an independent risk factor for future atherosclerotic morbidity.
A case-control study was conducted including women who delivered between the years 2000-2012 and subsequently developed atherosclerotic morbidity after their last delivery (n = 653) and matched controls (n = 4101). The mean follow-up duration was 57.7 ± 36.5 and 78.5 ± 42.3 months, respectively. The cases were further divided into: major events (severe atherosclerotic morbidity; n = 363), minor events (i.e. cardiovascular risk factors; n = 201) and cardiovascular evaluation tests (n = 89). The Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for hospitalizations while controlling for confounders.
A Cox proportional hazard model, controlling for confounders such as gestational hypertension, gestational diabetes mellitus, obesity, maternal age, creatinine level and gestational week at index pregnancy showed that K(+ )≥ 5.0 mEq/L during pregnancy was significantly associated with hospitalizations due to severe atherosclerotic morbidity (adjusted HR = 1.55; 95% CI 1.02-2.35; p = 0.039). A non-significant trend was also noted with long-term total hospitalizations for atherosclerotic (adjusted HR = 1.39; 95% CI 0.99-1.94; p = 0.052).
High potassium level during pregnancy is associated with a significant risk for severe atherosclerotic morbidity, as it might be an indication for occult metabolic and renal dysfunction.
本研究旨在确定孕期高钾水平是否为未来动脉粥样硬化发病的独立危险因素。
进行了一项病例对照研究,纳入2000年至2012年间分娩且在末次分娩后发生动脉粥样硬化发病的女性(n = 653)以及匹配的对照组(n = 4101)。平均随访时间分别为57.7±36.5个月和78.5±42.3个月。病例进一步分为:主要事件(严重动脉粥样硬化发病;n = 363)、次要事件(即心血管危险因素;n = 201)和心血管评估检查(n = 89)。使用Cox比例风险模型在控制混杂因素的同时估计住院的调整风险比(HR)。
一个控制了诸如妊娠期高血压、妊娠期糖尿病、肥胖、产妇年龄、肌酐水平和索引妊娠时孕周等混杂因素的Cox比例风险模型显示,孕期血钾(K +)≥5.0 mEq/L与因严重动脉粥样硬化发病导致的住院显著相关(调整后HR = 1.55;95%CI 1.02 - 2.35;p = 0.039)。对于动脉粥样硬化的长期总住院情况也观察到了一个不显著的趋势(调整后HR = 1.39;95%CI 0.99 - 1.94;p = 0.052)。
孕期高钾水平与严重动脉粥样硬化发病的显著风险相关,因为它可能是隐匿性代谢和肾功能不全的一个指征。