Hyánek J, Pehal F, Dubská L, Miková J, Gombíková L, Kubů S, Haláčková P, Feyereisl J, Táborský L
Ceska Gynekol. 2017 Winter;82(6):455-461.
Analysis of gestational hypercholesterolemia incidence in Prague population of healthy pregnant women. Diagnostic significance of non-cholesterol sterols as suitable markers of endogenous synthesis and intestinal absorption in etiology of gestational hypercholesterolemia.
Retrospective study.
From 21 000 healthy pregnant women set of 84 patients with blood level of total cholesterol >7.0 mmol/l where noncholesterol sterols had been analyzed by use of GC/MS method on Finnigan MAT 120b. Lathosterol and desmosterol as markers of endogenous syntesis and campesterol and sitosterol as markers for intestinal absorbtion. Classical lipid parameters have been analyzed on Beckman Coulter and Cobas analyzators.
The median of total cholesterol values in the set of 21 000 healthy pregnant women - 6,8 mmol/l was observed; median of LDLCh - 4.6 mmol/l and HDLCh - 2.2 mmol/l. The frequency of hypercholesterolemia values > 8.0 mmol/l 1:132 (!) was observed. The average values were for lathosterol 7.8 ± 1.7 µmol/l; desmosterol 4.7 ± 0.9 µmol/l; campesterol 9.8 ± 2.6 µmol/l; sitosterol 9.6 ± 3.8 µmol/l. The correlations of lathosterol with total cholesterol r = 0.524 as well as with non-HDLCh r = 0.35 and LDLCh r = 0.36 were observed. In campesterol or sitosterol as well as HDLCh or TAG no significant correlations have been observed.
Pilot study for gestational hypercholesterolemias in Czech population of healthy pregnant women proved the high frequency of increased levels of total cholesterol (> 8.0 mmol/l) 1:132. Increased levels of lathosterol values could explain the hypercholesterolemia in pregnancy as result of higher endogene synthesis of cholesterol.
Relatively high frequency of hypercholesterolemia in pregnancy is caused according to our findings by increased endogenous synthesis of cholesterol via lathosterol. The highly increased values of cholesterolemia during pregnancy could be efectivelly used for detection and after ending of lactation period for further differential diagnostic and treatment of previously undiagnosed familial hypercholesterolemias.
分析布拉格健康孕妇群体中妊娠性高胆固醇血症的发病率。非胆固醇甾醇作为内源性合成及肠道吸收的合适标志物在妊娠性高胆固醇血症病因学中的诊断意义。
回顾性研究。
从21000名健康孕妇中选取84名总胆固醇水平>7.0 mmol/l的患者，使用菲尼根MAT 120b气相色谱/质谱联用仪通过气相色谱/质谱法分析其非胆固醇甾醇。以羊毛甾醇和谷甾烷醇作为内源性合成的标志物，以菜油甾醇和谷甾醇作为肠道吸收的标志物。在贝克曼库尔特分析仪和科宝分析仪上分析经典脂质参数。
观察到21000名健康孕妇群体中总胆固醇值的中位数为6.8 mmol/l；低密度脂蛋白胆固醇中位数为4.6 mmol/l，高密度脂蛋白胆固醇中位数为2.2 mmol/l。观察到高胆固醇血症值>8.0 mmol/l的频率为1:132（！）。羊毛甾醇的平均值为7.8±1.7 µmol/l；谷甾烷醇为4.7±0.9 µmol/l；菜油甾醇为9.8±2.6 µmol/l；谷甾醇为9.6±3.8 µmol/l。观察到羊毛甾醇与总胆固醇的相关性r = 0.524，与非高密度脂蛋白胆固醇的相关性r = 0.35，与低密度脂蛋白胆固醇的相关性r = 0.36。在菜油甾醇或谷甾醇以及高密度脂蛋白胆固醇或甘油三酯之间未观察到显著相关性。
针对捷克健康孕妇群体中妊娠性高胆固醇血症的初步研究证明，总胆固醇水平升高（>8.0 mmol/l）的频率很高，为1:132。羊毛甾醇值升高可解释妊娠期间的高胆固醇血症是胆固醇内源性合成增加的结果。
根据我们的研究结果，妊娠期间高胆固醇血症的相对高频率是由通过羊毛甾醇的胆固醇内源性合成增加引起的。妊娠期间胆固醇血症的高度升高值可有效地用于检测，在哺乳期结束后可用于对先前未诊断的家族性高胆固醇血症进行进一步的鉴别诊断和治疗。
