Almekhaini Lolowa A, Awar Shamsa A, Zoubeidi Taoufik, Al Hamad Sania, Yasin Javed, George Junu V, Khaled Maha, Qasem Nehaya, Bahwan Fatima, Narchi Hassib, Aburawi Elhadi H
Departments of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates.
Obstetrics and Gynecology, United Arab Emirates University, Al-Ain, United Arab Emirates.
Reprod Health. 2024 Dec 18;21(1):185. doi: 10.1186/s12978-024-01940-9.
To study effect of pregnancy on obese women's maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.
This cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.
We enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.
This study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.
研究妊娠对肥胖女性母体心脏代谢生物标志物的影响,以此作为母体发病和并发症的特征。
这项横断面队列研究纳入了月经周期规律且血压正常的阿联酋孕妇。孕前体重指数通过本次妊娠前三个月内记录的身高和体重测量值计算得出。每次就诊时计算平均收缩压和舒张压测量值。随机采集一次血样并测量以下心脏代谢生物标志物。
我们纳入了178名孕妇,队列的平均年龄±标准差为29.9±4.97岁,孕前体重指数为28.11±6.58kg/m²。除可溶性细胞间细胞粘附分子-1水平在体重过轻的女性中最高外,孕前体重指数组间的血压测量值或生物标志物血清浓度在统计学上均无差异。与体重正常或超重的女性相比,孕前肥胖的孕妇收缩压和舒张压水平更高。除收缩压、随机血糖、脂蛋白-A和高敏C反应蛋白外,所有变量在孕期各阶段均有统计学显著差异。在多变量线性回归模型中,调整母体年龄、妊娠阶段、教育水平、产次和吸烟因素后,未发现生物标志物或血压与孕前体重指数有显著关联。在调整母体年龄、孕前体重指数、教育水平、产次和吸烟因素的多变量线性回归模型中,γ-谷氨酰转移酶、总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、载脂蛋白A和B、白细胞介素-6、肿瘤坏死因子-α和胰岛素样生长因子-1浓度仍与妊娠进展阶段显著相关。血清γ-谷氨酰转移酶和可溶性细胞间细胞粘附分子-1浓度在孕前体重指数和妊娠阶段之间存在显著交互作用。
本研究强调了妊娠对肥胖女性心脏代谢标志物有显著影响,表明妊娠的高脂血症状态以及非糖尿病肥胖患者的致糖尿病倾向。这些发现可能提示肥胖患者妊娠会增加未来发生代谢综合征的风险,因此建议对肥胖孕妇给予更多关注,并进一步研究建立特定的心脏代谢生物标志物筛查项目。