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妊娠高血压疾病 6 年后的母体血脂谱。

Maternal lipid profile 6 years after a gestational hypertensive disorder.

机构信息

Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.

Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

J Clin Lipidol. 2018 Mar-Apr;12(2):428-436.e4. doi: 10.1016/j.jacl.2017.12.010. Epub 2017 Dec 28.

Abstract

BACKGROUND

Gestational hypertensive disorders (GHDs), including gestational hypertension and preeclampsia, are associated with an increased risk of cardiovascular disease in later life, possibly through an atherogenic lipid profile.

OBJECTIVE

The objective of this study is to assess if women with a previous GHD have a more atherogenic lipid profile 6 years after pregnancy compared to women with a previous normotensive pregnancy.

METHODS

In a population-based prospective cohort study, we included 4933 women during pregnancy, including 302 women with a GHD. Six years after pregnancy, we determined maternal lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein[a], and apolipoprotein B) and glucose levels.

RESULTS

Women with a previous GHD had a more atherogenic lipid profile 6 years after pregnancy compared to women with a previous normotensive pregnancy. These atherogenic lipid profiles were a result of higher levels of triglycerides, low-density lipoprotein cholesterol, and apolipoprotein B and lower levels of high-density lipoprotein cholesterol. Differences in lipid profile between women with a previous GHD and women with a previous normotensive pregnancy were attenuated after adjustment for prepregnancy body mass index. Between women from both groups, no differences were observed in total cholesterol, lipoprotein[a], and glucose levels.

CONCLUSION

Women with a previous GHD show a more atherogenic lipid profile 6 years after pregnancy than women with a previous normotensive pregnancy. The increased risk of cardiovascular disease after a GHD might result from an atherogenic lipid profile after pregnancy, primarily driven by prepregnancy body mass index.

摘要

背景

妊娠高血压疾病(GHD),包括妊娠期高血压和子痫前期,与晚年心血管疾病风险增加相关,其机制可能与动脉粥样硬化脂质谱异常有关。

目的

本研究旨在评估与正常血压妊娠相比,既往有 GHD 的女性在妊娠后 6 年是否具有更易发生动脉粥样硬化的脂质谱。

方法

在一项基于人群的前瞻性队列研究中,我们纳入了 4933 名孕妇,其中 302 名患有 GHD。在妊娠后 6 年,我们测定了母亲的血脂谱(总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白[a]和载脂蛋白 B)和血糖水平。

结果

与正常血压妊娠相比,既往有 GHD 的女性在妊娠后 6 年具有更易发生动脉粥样硬化的脂质谱。这些动脉粥样硬化脂质谱的特征是甘油三酯、低密度脂蛋白胆固醇和载脂蛋白 B 水平升高,而高密度脂蛋白胆固醇水平降低。调整孕前体重指数后,GHD 组与正常血压妊娠组之间的脂质谱差异减弱。在两组女性之间,总胆固醇、脂蛋白[a]和血糖水平无差异。

结论

与正常血压妊娠相比,既往有 GHD 的女性在妊娠后 6 年具有更易发生动脉粥样硬化的脂质谱。GHD 后心血管疾病风险增加可能源于妊娠后动脉粥样硬化脂质谱异常,主要由孕前体重指数驱动。

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