van Stiphout W A, Hofman A, de Bruijn A M
Dept. of Epidemiology, Erasmus U. Medical School, Rotterdam, The Netherlands.
Am J Epidemiol. 1987 Nov;126(5):922-8. doi: 10.1093/oxfordjournals.aje.a114729.
The associations between pregnancy and serum lipids were investigated in a cohort of 831 Dutch women, initially aged 5-19 years. These women were examined yearly from 1975 to 1985 for an average period of six years, as part of a longitudinal survey of risk factors for coronary heart disease. During this period, 62 women became pregnant, and their serum total and high density lipoprotein (HDL) cholesterol levels were compared with those of an age-matched reference series of nonpregnant women, derived from the same cohort. Pregnant women showed higher total cholesterol levels (235 +/- 7.4 mg/100 ml) than nonpregnant women (205 +/- 2.7 mg/100 ml). Pregnant women also had higher levels of HDL cholesterol (66 +/- 2.1 mg/100 ml) than their referents (57 +/- 1.0 mg/100 ml). Total and HDL cholesterol increased with duration of pregnancy. When serum lipid levels of pregnant women were compared with the levels one year before and one year after pregnancy, it was observed that the year after pregnancy, HDL cholesterol levels dropped below pre-pregnancy concentrations. At the final examination, women who had ever been pregnant showed lower HDL cholesterol levels than those who had never been pregnant. The difference was most marked in users of oral contraceptives. These observations suggest that serum total and HDL cholesterol levels are elevated during pregnancy, probably because of hormonal changes. Furthermore, they point to a possibly lowering effect of parity on HDL cholesterol. These findings may help to explain the reported positive association between parity and the occurrence of cardiovascular diseases.
在一个由831名荷兰女性组成的队列中，对怀孕与血脂之间的关联进行了研究，这些女性最初年龄在5至19岁之间。作为冠心病危险因素纵向调查的一部分，从1975年到1985年，这些女性每年接受检查，平均检查期为六年。在此期间，62名女性怀孕，将她们的血清总胆固醇和高密度脂蛋白（HDL）胆固醇水平与来自同一队列的年龄匹配的未怀孕女性参考系列进行比较。孕妇的总胆固醇水平（235±7.4mg/100ml）高于未怀孕女性（205±2.7mg/100ml）。孕妇的HDL胆固醇水平（66±2.1mg/100ml）也高于其对照者（57±1.0mg/100ml）。总胆固醇和HDL胆固醇随着怀孕时间的延长而增加。当将孕妇的血脂水平与其怀孕前一年和怀孕后一年的水平进行比较时，发现怀孕后一年，HDL胆固醇水平降至怀孕前浓度以下。在最后一次检查时，曾经怀孕的女性的HDL胆固醇水平低于从未怀孕的女性。这种差异在口服避孕药使用者中最为明显。这些观察结果表明，怀孕期间血清总胆固醇和HDL胆固醇水平升高，可能是由于激素变化。此外，它们指出产次可能对HDL胆固醇有降低作用。这些发现可能有助于解释所报道的产次与心血管疾病发生之间的正相关关系。
