Study On Apolipoprotein B/A1 Ratio And Pregnancy Outcome Of Pregnant Women With Abnormal Lipid Metabolism During Pregnancy

Objective:Adaptively,lipid metabolism in pregnant women usually changes,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C).Apolipoprotein is also an important component of lipoprotein granules.Previous studies have shown that serum lipid levels and apolipoprotein levels play important roles in predicting pregnancy outcomes.Thus,this study will analyze the predictive effects of TC,TG,HDL,LDL,apolipoprotein A1,apolipoprotein B,apolipoprotein B/A1 in predicting preeclampsia,gestational diabetes mellitus,neonatal blood sugar and neonatal weight.Methods:66 pregnant women with abnormal lipid metabolism during pregnancy and 68pregnant women with normal blood lipid were collected as control group.The serum levels of TC,TG,HDL,LDL,apolipoprotein A1 and apolipoprotein B of 134pregnant women were measured by automatic biochemical instrument.Statistical analysis of the above data showed that the continuity data were expressed by mean and standard deviation,and single factor analysis was performed by t-test or chi-square test,with P<0.05 as the statistical significance.Results:134 pregnant women were enrolled in this study,including 66 pregnant women with abnormal lipid metabolism and 68 pregnant women with normal lipid metabolism.The survey data were as follows:(1)The average TC level of pregnant women in the study was(5.47±1.08)mmol/L,the average TG level was(3.16±1.42)mmol/L,the average HDL level was(1.99±0.48)mmol/L),and the average LDL level was(2.26±0.99)mmol/L,respectively.The average level of apolipoprotein B was(0.98±1.03)g/L,apolipoprotein A1 was(1.28±0.28)g/L and apolipoprotein B/apolipoprotein A1 was(0.79±0.15);(2)There was a high correlation between the level of blood lipid metabolism and pregnancy outcomes:the incidence of preeclampsia in normal lipid metabolism group was significantly lower than that in abnormal lipid metabolism group(~2=4.82,P=0.028);The incidence of diabetes mellitus in pregnant women with normal metabolism was significantly lower than that in abnormal lipid metabolism group(~2=8.27,P=0.004);the neonatal blood sugar level of pregnant women with abnormal lipid metabolism group was significantly lower than that of pregnant women with normal lipid metabolism group(3.40±0.57VS 3.15±0.73,P=0.026);and the neonatal weight level of pregnant women with normal lipid metabolism group was significantly lower than that of abnormal lipid metabolism group(3.40±0.57 VS 3.15±0.73,P=0.026).The neonatal weight level of pregnant women(3.08±0.76 VS 3.35±0.66,P=0.029);(3)Apolipoprotein B level,apolipoprotein A1 level and apolipoprotein B/A1 level also have unique value in predicting pregnancy outcomes of pregnant women:Apolipoprotein B level is positively correlated with the number of pregnant women with diabetes mellitus(r=0.287,P=0.020),apolipoprotein A1 level and the incidence of pregnant women with diabetes mellitus(r=0.287,P=0.020).Number was significantly negatively correlated(r=-0.264,P=0.002),apolipoprotein A1 level was positively correlated with neonatal blood glucose level(r=0.290,P=0.018),apolipoprotein B/A1 level was positively correlated with the number of pregnant women with diabetes mellitus(r=0.334,P<0.001),apolipoprotein B/A1 level was negatively correlated with neonatal blood glucose level(r=-0.196,P=0.023);(4)There was a significant negative correlation between apolipoprotein B/A1 level and neonatal blood glucos The expression of apolipoprotein B in pregnant women without gestational diabetes mellitus was significantly lower than that in pregnant women with gestational diabetes mellitus(0.97±0.11 VS 1.03±0.07,P=0.005),and the apolipoprotein B/A1 level in pregnant women without gestational diabetes mellitus was significantly lower than that in pregnant women with gestational diabetes mellitus(0.77±0.15 VS0.90±0.15,P<0.001).The apolipoprotein B level of pregnant women without neonatal macrosomia was significantly lower than that of pregnant women with neonatal macrosomia(0.97±0.10 VS 1.02±0.12,P=0.049).However,there was no significant difference in the levels of apolipoprotein A1,apolipoprotein B,apolipoprotein B/A1,apolipoprotein A1,apolipoprotein B/A1 and apolipoprotein B/A1 between pregnant women without preeclampsia and pregnant women without gestational diabetes mellitus,and no significant difference in the levels of apolipoprotein A1 and apolipoprotein A1 between pregnant women without gestational diabetes mellitus and pregnant women with gestational diabetes mellitus.There were no significant differences in the levels of apolipoprotein A1,apolipoprotein B/A1,apolipoprotein A1,apolipoprotein B/A1 and apolipoprotein B/A1 between pregnant women in hypoglycemia group and neonatal hypoglycemia group.There were no significant differences in the levels of apolipoprotein A1,apolipoprotein B/A1 and apolipoprotein A1 between pregnant women in non-neonatal macrosomia group and pregnant women in neonatal macrosomia group.There was no significant difference in B/A1 level.Conclusion:(1)The level of blood lipid metabolism during pregnancy is significantly correlated with the outcome of pregnant women and neonates.The incidence of gestational diabetes mellitus and preeclampsia in pregnant women with abnormal blood lipid metabolism is significantly higher than that in pregnant women with normal blood lipid metabolism,and the incidence of high birth weight and hypoglycemia in pregnant women with abnormal blood lipid metabolism is significantly higher than that in pregnant women with normal blood lipid metabolism;(2)Apolipoprotein B level was significantly correlated with the incidence of gestational diabetes,and apolipoprotein B positively predicted the occurrence of gestational diabetes,while apolipoprotein A1 negatively predicted the occurrence of gestational diabetes.However,there was no significant predictive effect on preeclampsia during pregnancy,neonatal weight and neonatal blood sugar.The risk of gestational diabetes mellitus and neonatal hypoglycemia was significantly higher in patients with high apolipoprotein B/A1 level,but apolipoprotein B/A1 level had no significant predictive effect on preeclampsia,neonatal blood sugar and neonatal weight.However,the effects of apolipoprotein A1,apolipoprotein B and apolipoprotein B/A1 on pregnancy outcomes of pregnant women need to be further explored in future studies.