Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, 1090 Vienna, Austria.
Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Nutrients. 2024 Aug 14;16(16):2704. doi: 10.3390/nu16162704.
Obesity in pregnancy is linked to adverse clinical outcomes such as gestational diabetes. Recently, a risk score calculated by different ceramide concentrations was recognized as a new way to investigate cardiovascular risk. The aim was to analyze if the ceramide risk score and cardiometabolic risk vary between normal-weight, obese, and females with prior Roux-en-Y bypass surgery (RYGB) during pregnancy.
Three cohorts were investigated: first, 25 pregnant females with a history of RYGB; second, 19 with preconception BMI ≥ 35 kg/m; and third, 19 normal-weight (preconception BMI < 25 kg/m). Around the 24th to 28th weeks of gestation routine laboratory assessments, 3 h 75 g oral and intravenous glucose tolerance tests were carried out. The correlation of ceramide risk scores and ceramide ratios (Cer(d18:1/18:0)/Cer(d18:1/16:0)) with metabolic parameters was analyzed via Pearson correlation. The cohorts were compared via ANOVA and unpaired -tests.
The RYGB cohort had lower ceramide risk scores and ratios compared to obese pregnant females (7.42 vs. 9.34, = 0.025; 0.33 vs. 0.47, < 0.001). Ceramide risk score and ratio were found to correlate negatively with insulin sensitivity (measured with the Matsuda (r = -0.376, = 0.031; r = -0.455, = 0.008) and calculated sensitivity index (r = -0.358, = 0.044; r = -0.621, < 0.001) in females without RYGB. The ceramide risk score correlated positively with body fat in RYGB females (r = 0.650, = 0.012).
We found that females after RYGB have lower ceramide risk scores and ceramide ratios compared to obese pregnant females, possibly indicating lower metabolic risk.
孕期肥胖与妊娠糖尿病等不良临床结局有关。最近，一种通过不同神经酰胺浓度计算得出的风险评分被认为是一种新的心血管风险研究方法。本研究旨在分析正常体重、肥胖和有 Roux-en-Y 旁路手术（RYGB）史的孕妇之间神经酰胺风险评分和心脏代谢风险是否存在差异。
研究纳入了三个队列：第一组为 25 名有 RYGB 史的孕妇；第二组为 19 名 BMI≥35kg/m²的孕妇；第三组为 19 名 BMI＜25kg/m²的正常体重孕妇。在妊娠 24 至 28 周时进行常规实验室检查、3 小时 75g 口服和静脉葡萄糖耐量试验。通过 Pearson 相关性分析，研究了神经酰胺风险评分和神经酰胺比值（Cer(d18:1/18:0)/Cer(d18:1/16:0)）与代谢参数的相关性。通过方差分析和独立样本 t 检验比较了各组之间的差异。
RYGB 组的神经酰胺风险评分和比值均低于肥胖孕妇（7.42 vs. 9.34，P=0.025；0.33 vs. 0.47，P＜0.001）。在无 RYGB 史的女性中，神经酰胺风险评分和比值与胰岛素敏感性呈负相关（Matsuda 指数：r=-0.376，P=0.031；r=-0.455，P=0.008；计算得出的敏感性指数：r=-0.358，P=0.044；r=-0.621，P＜0.001）。在 RYGB 女性中，神经酰胺风险评分与体脂呈正相关（r=0.650，P=0.012）。
本研究发现，与肥胖孕妇相比，RYGB 后的女性神经酰胺风险评分和比值较低，可能表明其代谢风险较低。
