Metabolic syndrome in normal and complicated pregnancies

Bartha, José Luis; Bugatto, Fernando; Fernández-Macías, Rosa; González-González, Nieves L.; Comino-Delgado, Rafael; Hervías-Vivancos, Blas

doi:10.1016/j.ejogrb.2007.06.011

Cited by 58 publications

(52 citation statements)

References 18 publications

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“…Pre-eclampsia has many characteristics similar to those of metabolic syndrome. [33][34][35] The observation that blood pressure was significantly higher (124/76 mm Hg on average vs 111/ 68 mm Hg on average, Po0.001) during the pregravid period or in first trimester is similar to findings of previous studies. 36 Most studies have not taken into account pre-gravid BMI that is associated both with increased insulin resistance and with pre-eclampsia.…”

Section: Pre-eclampsia and Dyslipidemiasupporting

confidence: 79%

Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia

Lei

Zhang

et al. 2010

J Hum Hypertens

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It is rare for a study to address immediate metabolic change in pre-eclamptic pregnancy. Our aim is to study the ante-partum and post-partum metabolic markers in pre-eclampsia. A total of 33 pre-eclamptic and 200 uncomplicated women with singleton pregnancies were recruited for the prospective research. Immediately ante-partum and 24-48 h postpartum venous blood samples were collected for the analysis of metabolic markers. In the pre-eclamptic group, the ante-partum fasting glucose, fasting insulin, triglyceride and free fatty acid levels were found to be higher than in the control group; however, ante-partum high-density lipoprotein level was lower. Interestingly, fasting glucose and insulin levels decreased by 24-48 h post-partum in both groups and no significant differences were found.Pre-eclamptic patients had lower post-partum highdensity lipoprotein (P ¼ 0.02), higher triglyceride (Po0.001), higher free fatty acid (P ¼ 0.02) and higher apolipoprotein B levels (P ¼ 0.01) than the control group. Dyslipidemia lasts from ante-partum to immediate postpartum in pre-eclamptic women in the form of increased triglyceride, higher free fatty acid and decreased highdensity lipoprotein levels. We speculate that women with dyslipidemia and higher baseline blood pressure tend to develop pre-eclampsia during pregnancy. Hence, the development of pre-eclampsia may be a 'marker' of possible future cardiovascular or metabolic disease.

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Section: Pre-eclampsia and Dyslipidemiasupporting

confidence: 79%

Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia

Lei

Zhang

et al. 2010

J Hum Hypertens

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“…Because CV risk factors increase along a continuum, it is likely that our study group had accrued, during their reproductive years, incipient circulating and functional CV risks and even vascular morphological changes. [37][38][39][40][41][42][43] This hypothesis is supported by a significant association of hypertension in pregnancy with chronic hypertension and by a borderline association with hyperlipidemia late in life. It is highly likely that conventional, arbitrary blood pressure cutoffs may not be valid in the face of the metabolic, hemodynamic, and immunologic challenges posed to the pregnant mother, as demonstrated by the association of preeclampsia with high-normal blood pressures.…”

Section: Discussionsupporting

confidence: 59%

“…27 Based on the hypothesis that hypertension in pregnancy expresses underlying maternal conditions, we propose that proteinuric versus nonproteinuric HPs relate to CV complications through 2 different pathophysiologic pathways. In proteinuric HP (ie, preeclampsia), there may be an underlying endothelial dysfunction because of CV risk factors, [23][24][25][26][27][28][29][30][31][32]34,35,[37][38][39][40][41][42][43] which is exacerbated and clinically expressed by increased syncytiotrophoblast debris shedded into the maternal circulation. 44 -50 In nonproteinuric HP (ie, transient hypertension or exacerbation of an underlying hypertension), there is a restricted capacity to stimulate vasodilatory and antiaggregating factors (eg, prostacyclin, 51 tissue kallikrein, 52 and angiotensin- [1][2][3][4][5][6][7] 53 ); this limitation hampers the adaptation to the systemic hemodynamic changes of pregnancy 54 -57 and may favor CV disease later in life.…”

Section: Discussionmentioning

confidence: 99%

Association of Remote Hypertension in Pregnancy With Coronary Artery Disease

Valdés¹,

Quezada²,

Marchant³

et al. 2009

Hypertension

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Abstract-Because hypertensive pregnancies have been associated with increased cardiovascular disease, we aimed to identify whether angiographically characterized coronary artery disease differed in women with previous normotensive pregnancies or hypertensive pregnancies (HPs Key Words: hypertension in pregnancy Ⅲ preeclampsia Ⅲ coronary artery disease Ⅲ cardiovascular risks Ⅲ coronary angiography I ndirect evidence has linked preeclampsia, other forms of hypertension in pregnancy, and placentation-related defects to cardiovascular (CV) disease later in life. [1][2][3][4][5][6][7][8][9][10][11][12] Although most studies have used registry bases, one includes clinical follow-up, 10 one compares women with angiographically characterized coronary lesions with patients who only underwent clinical screening for coronary disease, 8 and another evaluates coronary calcification, a predictor of coronary artery disease. 11 A prospective study performed in a cohort of women with a precise classification of obstetric outcomes would be necessary to evaluate the tentative association between reproductive and CV complications, but because this is a relatively new finding, any ongoing or new study will need at least a couple of decades to be completed. Furthermore, included subjects would have to be left to the natural evolution of CV disease, and it is ethically inadmissible to abstain from CV preventive management.We decided to take an intermediate stance, by testing whether those subjects who had hypertensive pregnancies (HPs) developed earlier or more extensive coronary lesions than controls who had normotensive pregnancies (NPs). For this purpose, we evaluated the remote obstetric histories in women who underwent coronary angiography, the gold standard for defining coronary disease. MethodsThis investigation was a case-control observational retrospective study, with the results of coronary angiography as the dependent variable. Women undergoing coronary angiographies because of suspected coronary disease at Hospital Sótero del Río, in the southeast zone of Santiago, Chile, from January 1, 2006, to December 31, 2007, completed a questionnaire (please see the online data supplement at http://hyper.ahajournals.org) to determine their CV risk factors, including the following: family history; age of onset and end of menstrual cycles; hormonal replacement therapy; number of

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“…2 Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are associated with an elevated risk of developing subsequent systemic hypertension and type II diabetes, affecting the cardiovascular system 3. Hyperlipidaemia, specifically hypertriglyceridaemia, is a well-known risk factor for metabolic syndromes.…”

Section: Introductionmentioning

confidence: 99%

Associations of lipid levels during gestation with hypertensive disorders of pregnancy and gestational diabetes mellitus: a prospective longitudinal cohort study

et al. 2016

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ObjectiveTo assess associations of elevated lipid levels during gestation with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM).MethodsThis prospective cohort study was conducted in a tertiary maternal hospital in Shanghai, China from February to November 2014. Lipid constituents, including triglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) of 1310 eligible women were assessed in the first (10–13+ weeks), second (22–28 weeks) and third (30–35 weeks) trimesters consecutively. Associations of lipid profiles with HDP and/or GDM outcomes were assessed.ResultsCompared with the normal group, maternal TG concentrations were higher in the HDP/GDM groups across the three trimesters (p<0.001); TC and LDL-c amounts were only higher in the first trimester for the HDP and GDM groups (p<0.05). HDL-c levels were similar in the three groups. Compared with intermediate TG levels (25–75th centile), higher TG amounts (>75th centile) were associated with increased risk of HDP/GDM in each trimester with aORs (95% CI) of 2.04 (1.41 to 2.95), 1.81 (1.25 to 2.63) and 1.78 (1.24 to 2.54), respectively. High TG elevation from the first to third trimesters (>75th centile) was associated with increased risk of HDP, with an aOR of 2.09 (1.16 to 3.78). High TG elevation before 28 weeks was associated with increased risk of GDM, with an aOR of 1.67 (1.10 to 2.54). TG elevation was positively correlated with weight gain during gestation (R=0.089, p=0.005).ConclusionsControlling weight gain during pregnancy could decrease TG elevation and reduce the risk of HDP/GDM. TGs could be used as follow-up parameters during complicated pregnancy, while other lipids are meaningful only in the first trimester.

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Metabolic syndrome in normal and complicated pregnancies

Cited by 58 publications

References 18 publications

Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia

Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia

Association of Remote Hypertension in Pregnancy With Coronary Artery Disease

Associations of lipid levels during gestation with hypertensive disorders of pregnancy and gestational diabetes mellitus: a prospective longitudinal cohort study

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