Amberbir Alemayehu, Ordnung Madeleine, Ishimwe Sage Marie Consolatrice, Biemann Ronald, Vogel Mandy, Kiess Wieland, Körner Antje, Nigatu Balkachew, Bazimya Darius, Uwizeyimana Theogene, Niyibizi Jean Baptiste, Seifu Daniel, Bekele Abebe, Genuneit Jon
Center for Population Health, University of Global Health Equity, Kigali, Rwanda.
Pediatric Epidemiology, Department of Pediatrics, Leipzig University, Leipzig, Germany.
J Glob Health. 2025 Jul 11;15:04206. doi: 10.7189/jogh.15.04206.
While cross-ancestral differences in glucose and lipid metabolism are widely reported in adults, there is a paucity of data on pregnant women during various stages of pregnancy. There is no consensus on what defines normal lipid ranges during pregnancy. Establishing reference ranges is crucial to reduce the risk of missing associated maternal and fetal health issues. Therefore, we aimed to investigate the metabolic profiles of healthy pregnant women and to establish national Rwandan reference ranges for these metabolites.
We derived the data from two ongoing longitudinal cohort studies conducted in predominantly rural Rwanda and urban Germany (Leipzig), providing repeat data from the second and third trimesters of pregnancy. We measured concentrations of glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and triglycerides (TG), and estimated their associations with trimesters and cohorts using multivariable linear regression. We estimated the reference ranges using the 5th and 95th percentiles for each metabolic marker.
For Rwanda and Leipzig, lipids and lipoproteins increased across trimesters, except for HDL, which remained equally low for Rwanda and significantly decreased for Leipzig. Concentrations of TC, low-density lipoprotein, and non-HDL were significantly higher in Leipzig compared to Rwanda for both trimesters, while HDL was significantly lower in Rwanda. Rwanda exhibited significantly higher TG levels in the second trimester than Leipzig, although this difference did not persist into the third trimester. Glucose concentrations were significantly higher in Rwanda than in Leipzig for both trimesters.
This is the first representative study investigating lipid and lipoprotein concentrations in pregnant women from Rwanda and comparing them to a European sample. This study shows that lipid, lipoprotein, and glucose concentrations differ by ancestry and stage of pregnancy. The higher TG and glucose concentrations in Rwanda may indicate an emerging burden of metabolic disorders in Africa.
虽然成人中葡萄糖和脂质代谢的跨祖先差异已被广泛报道，但关于孕期各阶段孕妇的数据却很匮乏。对于孕期正常脂质范围的定义尚无共识。建立参考范围对于降低遗漏相关母婴健康问题风险至关重要。因此，我们旨在调查健康孕妇的代谢谱，并为这些代谢物建立卢旺达全国参考范围。
我们从在卢旺达农村和德国莱比锡主要地区进行的两项正在进行的纵向队列研究中获取数据，提供妊娠中期和晚期的重复数据。我们测量了葡萄糖、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL）和甘油三酯（TG）的浓度，并使用多变量线性回归估计它们与孕期和队列的关联。我们使用每个代谢标志物的第5和第95百分位数估计参考范围。
对于卢旺达和莱比锡，脂质和脂蛋白在孕期各阶段均升高，但HDL除外，卢旺达的HDL一直较低，而莱比锡的HDL则显著下降。两个孕期中，莱比锡的TC、低密度脂蛋白和非HDL浓度均显著高于卢旺达，而卢旺达的HDL显著较低。卢旺达在妊娠中期的TG水平显著高于莱比锡，尽管这种差异在妊娠晚期并未持续。两个孕期中，卢旺达的葡萄糖浓度均显著高于莱比锡。
这是第一项调查卢旺达孕妇脂质和脂蛋白浓度并与欧洲样本进行比较的代表性研究。该研究表明，脂质、脂蛋白和葡萄糖浓度因祖先和孕期阶段而异。卢旺达较高的TG和葡萄糖浓度可能表明非洲代谢紊乱负担正在显现。
