#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Lipid and lipoprotein levels in normal and complicated pregnancies


Authors: Z. Kokrdová;  M. Košťál
Authors‘ workplace: Fakulta zdravotnických studií, Univerzita Pardubice, děkan prof. MUDr. A. Pellant, DrSc. ;  Gynekologicko-porodnická klinika, Pardubická krajská nemocnice, a. s., Pardubice, přednosta doc. MUDr. M. Košťál, CSc.
Published in: Ceska Gynekol 2013; 78(5): 412-419
Category: Original Article

Overview

Objective:
Lipid and lipoprotein levels during pregnancy and postpartum were compared in healthy pregnant women and in high risk pregnancy groups including women with pre-existing metabolic syndrome. The second half of a normal pregnany is accompanied by hyperlipidaemia and glucose intolerance. Physiological response to pregnancy represents a transient excursion into a metabolic syndrome.

Design:
Clinical study.

Setting:
Department of Obstetrics and Gynaecology, Regional Hospital Pardubice, Faculty of Health Studies, University of Pardubice.

Methods:
Fasting plasma lipid and lipoprotein levels were studied in 54 women during pregnancy and postpartum at the Regional Hospital Pardubice. The group of patients consisted of 25 healthy pregnant women,11 women with gestational diabetes, 9 women with diabetes type 1 and 9 women with pre-existing metabolic syndrome. The results were compared to measurements in 30 non-pregnant healthy controls.

Results:
Total triglyceride levels in late gestation were at least but significantly (p < 0.001) elevated above those in non-pregnant controls in the group of patiens with pre-existing metabolic syndrome. In the same group, in kontrast with other groups, no changes in plasma cholesterol and LDL-cholesterol were found in late pregnancy. However, signifiant decline in HDL-cholesterol, when compared to non-pregnant controls, was observed 6 and 24 months postpartum only in the group of women with pre-existing metabolic syndrome (p < 0.01, p < 0.001 respectively).

Conclusion:
The gynaecologist may be the first physician that a woman of reproductive age and with a metabolic syndrome encounters, it is important to suspect the presence of this syndrome and inform the woman about the most notable clinical implications.

Keywords:
hyperlipidaemia – insulin resistance – metabolic syndrome – pregnancy


Sources

1. Alberti, KG., Eckel, RH., Grundy, SM., et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation task force on epidemiology and prevention; National Heart, Lung and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the study of Obesity. Circulation, 2009, 120(16), p. 1640–1645.

2. Ben-Haroush, A., Yogev, Y., Hod, M. Epidemiology of gestational diabetes mellitus and its association with type 2 diabetes. Diabet Med, 2004, 21(2), p. 103–113.

3. Dunaif, A. Insulin resistence and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev, 1997, 18(6), p. 774–800.

4. Gunderson, EP. Prospective evidence that lactation protects against cardiovascular disease in women. Am J Obstet Gynecol, 2009, 200(2): p. 119–120.

5. Jimenez, DM., Pocovi, M., Ramon-Cajal, J., et al. Longitudinal study of plasma lipids and lipoprotein cholesterol in normal pregnancy and puerperium. Gynecol Obstet Invest, 1988, 25(3), p. 158–164.

6. Knopp, RH., Bergelin, RO., Wahl, PW., et al. Population-based lipoprotein lipid references values for pregnant women compared to nonpregnant women classified by sex hormone usage. Am J Obstet Gynecol, 1982, 143(6), p. 626–437.

7. Korhonen, S., Hippeläinen, M., Niskanen, L., et al. Relationship of the metabolic syndrome and obesity to polycystic ovary syndrome: a controlled, population-based study. Am J Obstet Gynecol, 2001, 184, p. 289–296.

8. Lewis, CE., Funkhouser, E., Raczynski, JM., et al. Adverse effect of pregnancy on high density lipoprotein (HDL) cholesterol in young adult women. The CARDIA study. Coronary Artery Risk Development in Young Adults. Am J Epidemiol, 1996, 144(3), p. 247–254.

9. Malik, S., Budoff, MJ., Katz, R., et al. Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the multi-ethnic study of atherosclerosis. Diabetes Care, 2011, 34(10), p. 2285–2290.

10. Mazurkiewicz, JC., Watts, GF., Warburton, FG., et al. Serum lipids, lipoproteins and apolipoproteins in pregnant non-diabetic patients. J Clin Pathol, 1994, 47(8), p. 728–731.

11. McNamara, JR., Campos, H., Ordovas, JM., et al. Effect of gender, age, and lipid status on low density lipoprotein subfraction distribution. Results from the Framingham offspring study. Arteriosclerosis, 1987, 7(5), p. 483–490.

12. McNamara, JR., Jenner, JL., Li, Z., et al. Change in LDL particle size is associated with change in plasma triglyceride concentration. Arterioscler Tromb, 1992, 12(11), p. 1284–1290.

13. Piechota, W., Staszewski, A. Refecence ranges of lipids and apolipoproteins in pregnancy. Europ J Obstet Gynecol Reprod Biol, 1992, 45(1), p. 27–35.

14. Reaven, GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes, 1988, 37(12), p. 1595–1607.

15. Rosolová, H. Současné farmakoterapeutické možnosti metabolického syndromu inzulinové rezistence. Remedia, 2004, 14, s. 307–313.

16. Rybka, J. Trnitá cesta metabolického syndromu prosadit se v praxi. Vnitř Lék, 2010, 56(7), s. 727–735.

17. Sattar, N., Gaw, A., Scherbakova, O., et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in West of Scotland Coronary Prevention Study. Circulation, 2003, 108(4), p. 414–419.

18. Sattar, N., Greer, IA. Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening? BMJ, 2002, 325(7356), p. 157–160.

19. Sattar, N., Greer, IA., Louden, J., et al. Lipoprotein subfraction changes in normal pregnancy: threshold effect of plasma triglyceride on appearance of small, dense low density lipoprotein.J Clin Endocrinol Metab, 1997, 82(8), p. 2483–2491.

20. Taylor, AE. Understanding the underlying metabolic abnormalities of polycystic ovary syndrome and their implications. Am J Obstet Gynecol, 1998, 179, p. 94S–100S.

21. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation, 2002, 106(25), p. 3143–3421.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#