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孕期血脂水平与子痫前期、妊娠期糖尿病及早产的关联

Association of Lipid Profile in Pregnancy with Preeclampsia, Gestational Diabetes Mellitus, and Preterm Delivery.

作者信息

Ghodke Babita, Pusukuru Raghuram, Mehta Varshil

机构信息

Department of Medicine, MGM Medical College, Navi Mumbai, India.

Department of Internal Medicine, MGM Medical College, Navi Mumbai, India.

出版信息

Cureus. 2017 Jul 3;9(7):e1420. doi: 10.7759/cureus.1420.

Abstract

Introduction During the last two trimesters of pregnancy, glucose is spared (for the foetus), while the concentration of fatty acids in plasma increases, which can create complications like preeclampsia, gestational diabetes mellitus (GDM), and preterm delivery. Aim To study the association of serum lipid levels during the second and third trimesters with the development of pregnancy-associated diseases, such as preeclampsia, GDM, and preterm delivery. Methods and Materials The present study was carried out at MGM Hospital, Navi Mumbai, India. Two hundred antenatal cases from October 2012 to October 2014 were enrolled after giving an informed consent. A lipid profile was recorded for each subject and was later accessed. The lipid profile of the subjects having either GDM, preterm, or preeclampsia was further used to find an association with the individual disorders. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY). All reported p-values are two-tailed, and confidence intervals were calculated at the 95% level. Results In preeclamptic patients, the mean systolic blood pressure was 151.40 mm/Hg and the mean diastolic blood pressure was 74.03 mm/Hg in the third trimester. In preeclamptic patients, the mean serum triglyceride levels in the second trimester were 204.00 mg/dl, while the mean was 243.20 mg/dl in the third trimester. In GDM patients, the mean serum triglyceride was 214.33 mg/dl in the second trimester, while it was 230.50 mg/dl in the third trimester. In patients with preterm, the mean triglycerides levels were 212.83 mg/dl and 240.16 mg/dl in the second and third trimesters, respectively. In preeclamptic patients, the mean serum cholesterol levels in the second trimester were 210 mg/dl, while in the third trimester, the mean was 243.60 mg/dl. In GDM patients, the mean serum cholesterol was 223.50 mg/dl and 242.83 mg/dl in the second and third trimester, respectively. The mean cholesterol levels in patients with preterm in second and third trimesters were 213.33 mg/dl and 243.66 mg/dl, respectively. Out of the total 200 patients, 168 had no complications, while 20 (10%) had preeclampsia, six (3%) had gestational diabetes mellitus, and the other six {3%} had preterm deliveries. Conclusion An association between maternal early pregnancy triglyceridaemia and the subsequent risk of preeclampsia, gestational diabetes, and preterm deliveries was observed. The occurrence of preeclampsia, gestational diabetes, and preterm deliveries cannot be predicted based on the values of serum cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very-low-density lipoprotein cholesterol (VLDL-C). Hence, estimation of lipid profile is strongly recommended during pregnancy to prevent the deleterious effect of hyperlipidaemia associated with pregnancy.

摘要

引言 在妊娠的最后两个阶段,葡萄糖(为胎儿)被节省下来,而血浆中脂肪酸的浓度增加,这可能会引发子痫前期、妊娠期糖尿病(GDM)和早产等并发症。

目的 研究妊娠中期和晚期血清脂质水平与子痫前期、GDM和早产等妊娠相关疾病发生发展的关联。

方法和材料 本研究在印度新孟买的MGM医院进行。2012年10月至2014年10月的200例产前病例在获得知情同意后被纳入研究。记录每个受试者的血脂谱,随后进行分析。患有GDM、早产或子痫前期的受试者的血脂谱进一步用于寻找与个体疾病的关联。使用社会科学统计软件包(SPSS)20版(IBM SPSS Statistics,纽约州阿蒙克)进行统计分析。所有报告的p值均为双侧,置信区间在95%水平计算。

结果 子痫前期患者在妊娠晚期的平均收缩压为151.40 mmHg,平均舒张压为74.03 mmHg。子痫前期患者在妊娠中期的平均血清甘油三酯水平为204.00 mg/dl,而在妊娠晚期平均为243.20 mg/dl。GDM患者在妊娠中期的平均血清甘油三酯为214.33 mg/dl,而在妊娠晚期为230.50 mg/dl。早产患者在妊娠中期和晚期的平均甘油三酯水平分别为212.83 mg/dl和240.16 mg/dl。子痫前期患者在妊娠中期的平均血清胆固醇水平为210 mg/dl,而在妊娠晚期平均为243.60 mg/dl。GDM患者在妊娠中期和晚期的平均血清胆固醇分别为223.50 mg/dl和242.83 mg/dl。早产患者在妊娠中期和晚期的平均胆固醇水平分别为213.33 mg/dl和243.66 mg/dl。在总共200名患者中,168名无并发症,20名(10%)患有子痫前期,6名(3%)患有妊娠期糖尿病,另外6名(3%)发生早产。

结论 观察到孕妇孕早期甘油三酯血症与随后子痫前期、妊娠期糖尿病和早产风险之间存在关联。子痫前期、妊娠期糖尿病和早产的发生不能基于血清胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和极低密度脂蛋白胆固醇(VLDL-C)的值来预测。因此,强烈建议在孕期评估血脂谱,以预防与妊娠相关的高脂血症的有害影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/371c/5580975/9fae9193269e/cureus-0009-00000001420-i01.jpg

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