Heterogeneity of lipid metabolism in patients with pregnancy-specific complications during different pregnancies and its clinical monitoring significance
Zeng Guihong, Zou Weiyang, Liu Changdi, et al
1. Department of Obstetrics,Fuyong People's Hospital of Shenzhen Bao'an District, Guangdong, Shenzhen 518103, China; 2. Department of Clinical Laboratory, Fuyong People's Hospital, Bao 'an District, Guangdong, Shenzhen 518103, China
Abstract: 【Abstract】 Objective To investigate the heterogeneity of lipid metabolism among pregnant women with pregnancy-specific complications such as pre-eclampsia (PE), gestational diabetes mellitus (GDM) and intrahepatic cholestasis of pregnancy (ICP). Method A total of 185 pregnant women who were registered and gave birth in Fuyong People's Hospital, Bao 'an District, Shenzhen from June 2020 to December 2021 were selected as the research objects. They were grouped according to whether they had pregnancy-specific complications and their type: including normal pregnant women as control group (n=60). Pregnant women with PE, GDM and ICP were included in PE group (n=35), GDM group (n=45) and ICP group (n=45), respectively. Comparison of the general data of pregnant woman in each group, the first trimester (8- 12 weeks), the second trimester (24-28 weeks), the third trimester (32-34 weeks) [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), lysophosphatidic acid (Lpa)] levels, and the incidence of adverse pregnancy outcomes in each group and the blood lipid levels in the third trimester between those with and without adverse pregnancy outcomes were statistically compared. The value of blood lipid levels in the third trimester in predicting the adverse pregnancy outcomes of pregnant women with pregnancy complications was analyzed by receiver operator characteristic (ROC) curve. The statistical methods performed by t test, χ2 test and one-way analysis of variance. Result The plasma levels of TG, TC, HDL-C, LDL-C, ApoA, ApoB and Lpa in each group were the third trimester > the second trimester > the first trimester (all P<0.05). The levels of plasma HDL-C and Lpa in PE group, GDM group and ICP group were higher than those in control group in the second trimester [HDL-C: (2.8±0.6), (2.9±0.7), (2.7±0.6), (2.3±0.6) mmol/L, F=8.640, P<0.001]; Lpa: (4.0±0.7), (4.2±0.7) ,(3.9±0.6),(3.1±0.5) mmol/L, F=29.874, P<0.001], and the levels of blood lipids PE group, GDM group and ICP group were higher than those in control group in the third trimester (all P<0.05). The incidence of adverse pregnancy outcomes in PE group, GDM group and ICP group was higher than that in control group [22.9% (8/35), 24.4%(11/45), 20.0%(9/45), 5.0%(3/60), χ2=9.125, P<0.05)]; Among the pregnant women with complications during pregnancy, the levels of blood lipid in the third trimester in the group with adverse pregnancy outcome were higher than those in the group without adverse pregnancy outcome [TG: (4.2±0.9), (3.6±0.8) mg/L, t=3.398, P<0.001; TC: (7.6±0.8), (7.0±0.8) mmol/L, t=3.496,P<0.001; HDL-C: (3.6±0.6) ,(3.2±0.6) mmol/L, t=3.108, P=0.002; LDL-C: (5.0±0.6), (4.4±0.5) mmol/L,t=5.342, P<0.001; ApoA: (2.1±0.5), (1.8±0.3) g/L, t=3.953, P<0.001; ApoB: (1.7±0.2), (1.5±0.2) g/L,t=4.661, P<0.001; Lpa: (6.7±0.8), (6.0±0.7) μmol/L, t=4.512, P<0.001]. The area under the curve (AUC) predicted by each index alone was greater than 0.7, and the AUC predicted by the joint prediction was the largest, which was 0.924 (95%CI: 0.863-0.964). Conclusion The pregnancy-specific complications are closely related to lipid metabolism abnormality, and the blood lipid levels tend to increase with the progress of pregnancy. Dynamic detection of their blood lipid levels and effective interventions can effectively improve their pregnancy outcomes.
曾贵红 邹伟洋 刘长娣 陈玉兰 温婷媚. 妊娠期特有并发症患者不同孕期脂代谢异质性及临床监测意义[J]. 发育医学电子杂志, 2023, 11(3): 174-180.
Zeng Guihong, Zou Weiyang, Liu Changdi, et al. Heterogeneity of lipid metabolism in patients with pregnancy-specific complications during different pregnancies and its clinical monitoring significance. Journal of Developmental Medicine(Electronic Version), 2023, 11(3): 174-180.
2023, Vol. 11 
