Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
Sci Rep. 2022 Feb 7;12(1):2009. doi: 10.1038/s41598-022-05919-z.
Metabolic syndrome (MetS) in pregnancy shows epigenetic associations with intergenerational inheritance of metabolic diseases. The presence of different diagnostic criteria influences MetS prevalence estimates. We evaluated MetS and metabolic derangements to determine the utility of its assessment in early pregnancy. A cross-sectional analysis of metabolic derangements in pregnant women with period of gestation (POG) ≤ 12 weeks was done among Rajarata Pregnancy Cohort participants in Sri Lanka. 2682 women with mean age 27.9 year (SD-5.5) and median POG 8.0wk (IQR-3) were analyzed. Mean levels of triglycerides (TG), total cholesterol (TC), high-density-lipoprotein (HDL), low-density-lipoprotein (LDL), fasting plasma glucose, and 2 h oral glucose tolerance test were 87.71 (SD 38.7), 172.2 (SD 34.7), 49.6 (SD 11.5), 122.6 (SD 32.3), 82.2 (SD 12.8) and 120.3 (SD 11.5) respectively. All serum lipids except LDL increase significantly from 6 to 12 weeks, with TG by 23 and TC by 8 units. High MetS prevalence was observed with AHA/NHLBI (n = 150, 5.6%, 95% CI 4.8-6.5) followed by IDF (n = 144, 5.4%, 95% CI 4.6-6.3), NCEP-ATP III (n = 112, 4.2%, 95% CI 3.4-5.0) and WHO (n = 81, 3.0%, 95% CI 2.4-3.7) definitions respectively. Significant difference in prevalence was noted among different sociodemographic characteristics (p < 0.001). Regardless of the criterion used, the change of metabolic parameters in early pregnancy leads to significant differences in prevalence estimates of MetS. The best MetS definition concerning pregnancy outcomes needs to be determined with prospective studies.
代谢综合征 (MetS) 在妊娠期间与代谢疾病的代际遗传有关，表现出表观遗传关联。不同的诊断标准的存在影响 MetS 患病率的估计。我们评估了代谢综合征和代谢紊乱，以确定其在早孕时评估的效用。在斯里兰卡的拉贾拉特纳妊娠队列参与者中，对妊娠 12 周（POG）≤ 12 周的孕妇进行了代谢紊乱的横断面分析。分析了 2682 名年龄 27.9 岁（SD-5.5）、平均妊娠周数 8.0 周（IQR-3）的女性。甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、空腹血糖和 2 小时口服葡萄糖耐量试验的平均水平分别为 87.71（SD 38.7）、172.2（SD 34.7）、49.6（SD 11.5）、122.6（SD 32.3）、82.2（SD 12.8）和 120.3（SD 11.5）。除 LDL 外，所有血清脂质从 6 周到 12 周均显著增加，TG 增加 23 单位，TC 增加 8 单位。美国心脏协会/美国国立卫生研究院（AHA/NHLBI）（n = 150，5.6%，95%CI 4.8-6.5）、国际糖尿病联合会（IDF）（n = 144，5.4%，95%CI 4.6-6.3）、美国国家胆固醇教育计划（NCEP-ATP III）（n = 112，4.2%，95%CI 3.4-5.0）和世界卫生组织（WHO）（n = 81，3.0%，95%CI 2.4-3.7）的定义显示出较高的 MetS 患病率。不同的社会人口特征之间存在显著差异（p < 0.001）。无论使用哪种标准，妊娠早期代谢参数的变化都会导致 MetS 患病率的估计值显著不同。需要前瞻性研究来确定与妊娠结局相关的最佳 MetS 定义。
