| Objective: We analysed the metabolic syndrome (MS) phenotypes of pre-eclampsia (PE) in order to elucidate the similar mechanisms exists between PE and MS,; and explore diagnostic criteria for metabolic syndrome during pregnancy .Methods: 413 objects were enrolled in this study, which include 178 pre-eclampsia women with singleton and 253 normal pregnant women as a control . They were selected in Department of Obstetrics of the Guangdong Women and Children's Hospital and Health Institute from September 2009 to March 2011. There was no significant difference of age ,pregnancies and gestational age between the two groups. GDM was diagnosed according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) certeria . MS was definition according to Chinese Diabetes Society of Metabolic Syndrome Study Group(CDS) certeria . Blood samples were collected after patients had fasted for 10 hours. Biochemical tests performed with peripheral blood included fasting plasma glucose(FPG),insulin,total cholesterol(TC) ,high-density lipoproteins (HDL) ,low-density lipoproteins (LDL) , triglycerides (TG),free fatty acids(FFA), apolipoprotein A1 ( APO-A1 ) and apolipoprotein B(APO-B). FPG, TC, HDL, LDL, FFA, TG, APO-A1 and APO-B were analyzed. Insulin resistance was calculated using the homeostasis model assessment ratio (HOMA-IR). Prevalence of the metabolic syndrome was calculated by adapting the definition of the metabolic syndrome to pregnancy. Statistical analysis was performed with the SPSS 13.0 software. Results were expressed as frequency, mean, and standard deviation. The t tests,χ2 tests and Spearman correlation coefficient were used,α= 0.05, (P < 0.05) was considered significant.Results:1.As expected, patients with PE had significantly larger pre-pregnancy BMI than the controls(23.26±2.58vs21.95±3.12,P<0.01), Compared to the controls, the PE group also had significantly higher TG (4.38±1.57 mmol/L vs 2.92±1.09 mmol/L,P=0.015), FFA(776.12±209.96 mmol/L vs 530.35±273.39 mmol/L,P=0.000), FPG (4.66±0.90mmol/L vs 4.31±0.55 mmol/L, P=0.012), HOMA-IR levels(2.32±1.25 vs 1.95±1.15, P=0.015).2. By using spearman correlation coefficient We found Pre-BMI, FFA, TG, TC, FBG have significant correlations with HOMA-IR(r=0.158,0.217, 0.195, 0.082, 0.137,P<0.05) . Metabolic syndrome during pregnancy was definition according to CDS certeria , with adaptation used due to the special physiology of pregnancy. The proportion of women with insulin resistance, GDM, gestational hypertension, hyperglycemia, obese was significantly increased in the study group in comparison with controls, (P<0.01). The proportion of women with the metabolic syndrome was significant higher in women with PE than in control group (32.02% vs 0.40%,P=0.000).Conclusion:1. Compared with normal pregnancy, there are more obvious insulin resistance, abnormal glucose metabolism, abnormal lipid metabolism in PE pregnant women.2. Part of the pregnant women with PE presents obesity, hypertension, high cholesterol, insulin resistance, hyperglycemia and other metabolic syndrome phenotype.3. The diagnostic criteria of metabolic syndrome for general population does not serve for pregnant women, it is necessary to develop evaluation criteria of metabolic syndrome.in pregnance based on physiological characteristics of metabolic changes during pregnancy.4. According to the revised evaluation criteria of metabolic syndrome during pregnancy, gestational metabolic syndrome occurs in about 30% pregnant women with PE.5. The relevance of PE and MS proved by this study provids ideas for prevention, treatment and follow-up of PE.. With guidance on appropriate diet and lifestyle for women in pregnant and planning pregnancy ,Control of weight and blood glucose ,active lipid treatment, reducing insulin resistance, the incidence of pre-eclampsia may decrease,which can lessen the incidence of future metabolic syndrome, cardiovascular disease and type 2 diabetes . New theories may be obtained by further studies on metabolism during pregnancy. |
PDF Full Text Request