Study On The Relationship Between Serum Lipids,Uric Acid Levels And Preeclampsia In The Third Trimester Of Pregnancy

Object:Abnormal metabolism of blood lipid and uric acid can cause serious adverse pregnancy outcomes,such as diabetes in pregnancy,acute pancreatitis,pre eclampsia,preterm labor,fetal growth restriction,fetal distress,macrosomia,and even endanger the lives of mothers and infants in serious cases.The purpose of this study is to analyze the levels of blood lipids and uric acid in patients with preeclampsia,compare them with those of healthy pregnant women,and explore the correlation between the levels of blood lipids and uric acid in pregnant women in the third trimester of pregnancy and the occurrence and severity of preeclampsia,so as to guide the pregnant women with abnormal indicators to conduct adequate prenatal counseling as soon as possible,so as to promote them to develop healthier habits and lifestyle,and conduct regular inspections,In order to find and intervene in time at the early stage of the disease,before causing irreparable damage or even death,and improve the maternal and infant outcomes.Methods:The patients with preeclampsia diagnosed during hospital delivery in the Second Hospital of Jilin University from January 2019 to December 2022 were selected as the case analysis group.They were divided into two subgroups: 48 in the preeclampsia group and 92 in the severe preeclampsia group.136 normal pregnant women who delivered at the same time without other complications were selected as the case control group.The age,parity,height,weight,weight gain during pregnancy,termination of pregnancy,blood pressure(BP)Blood lipids(TC,TG,HDL-C,LDLC,FFA,Lp-a,ApoB,ApoA1,LDL-C/HDL-C,ApoA1/ApoB),uric acid level and pregnancy outcome(delivery mode,newborn weight,newborn sex,etc.)clinical data information,and the correlation between the above indicators and the occurrence and development of preeclampsia was analyzed by multivariate logistic regression analysis.Results:1.In terms of general data,there were significant differences in BMI and neonatal weight between pre-eclampsia group and normal pregnancy group(P<0.05);There were significant differences in gestational weeks,BMI and neonatal weight between severe preeclampsia group and normal pregnancy group(P<0.05);Compared with severe preeclampsia group and preeclampsia group,there were statistically significant differences in gestational weeks and neonatal weight(P<0.05).2.In terms of blood lipid index and UA,the levels of TC,TG,LDL-C,LDLC/HDL-C and UA in preeclampsia group were significantly higher than those in normal pregnancy group(P<0.05);The levels of TC,TG,LDL-C,LDL-C,HDL-C,ApoA1,ApoB,LP-a,ApoA1/ApoB,FFA and UA in severe preeclampsia group were significantly higher than those in normal pregnancy group(P<0.05);There were significant differences in TC,TG,LDL-C and LDL-C/HDL-C,ApoB,LP-a,ApoA1/ApoB,FFA and UA between severe preeclampsia group and preeclampsia group(P<0.05).3.To explore the multifactor analysis on the occurrence of pre-eclampsia,with the occurrence of pre-eclampsia as the dependent variable,age,gestational age and BMI as the control variable,TC,TG,HDL-C,LDL-C,LDL-C/HDL-C,ApoA1,ApoB,ApoA1/ApoB,LP-a,FFA and UA as the independent variable,and adopt the method of forward step(likelihood ratio)to screen out the gestational age,BMI,TG,TC,ApoA1 Seven variables of ApoB and UA were used to construct the binary logistic regression model and ROC curve.It was found that gestational week(OR=0.730,95% CI 0.622-0.856,P=0.000<0.05),BMI(OR=1.269,95% CI 1.158-1.390,P=0.000<0.05),TG(OR=1.457,95% CI 1.139-1.863,P=0.003<0.05),TC(OR=4.533,95% CI 2.101-9.783,P=0.000<0.05),ApoA1(OR=0.972,95% CI 0.959-0.985,P=0.000<0.05)ApoB(OR=0.968,95% CI 0.941-0.995,P=0.023<0.05)and UA(OR=1.006,95% CI 1.002-1.010,P=0.004<0.05)had statistically significant effects on preeclampsia.The increase of BMI,TG,TC,UA,ApoB and the decrease of ApoA1 are all risk factors for preeclampsia.When the serum uric acid level is more than 358.50 umol/,it has certain predictive value for the occurrence of preeclampsia(P=0.000<0.05,AUC=0.752,95% confidence interval=0.695 – 0.710),sensitivity61.4%,specificity 79.4%.4.To explore the multifactor analysis on the prevalence of preeclampsia,with the prevalence of preeclampsia as the dependent variable,age,gestational week and BMI as the control variable,and TC,TG,HDL-C,LDL-C,LDL-C/HDL-C,ApoA1,ApoB,ApoA1/ApoB,LP-a,FFA and UA as the independent variables,the gestational week,BMI,TC The five variables of LP-a and FFA were used to construct the binary logistic regression model and ROC curve.It was found that the gestational week had statistical significance for the prevalence of preeclampsia(OR=0.642,95% CI 0.526-0.784,P=0.000<0.05),indicating that the time of termination of pregnancy was correlated with the severity of preeclampsia;TC was a risk factor for the severity of preeclampsia(OR=1.505,95% CI 1.047-2.165,P=0.027<0.05);When FFA >0.8mmol/l,it has certain predictive value for the severity of preeclampsia(P=0.028 <0.05,AUC=0.613,95% confidence interval=0.517 – 0.709),sensitivity 35.9%,specificity 87.5%.Conclusion:1.Compared with the normal pregnancy group,the levels of TC,TG,LDL-C,LDL-C and HDL-C in patients with preeclampsia were increased,and further increased in patients with severe preeclampsia,indicating that these indicators were related to the occurrence and severity of preeclampsia.2.LP-a,FFA,ApoB in severe preeclampsia group were significantly higher than those in preeclampsia group and normal pregnancy group,while ApoA1/ApoB was negatively correlated with preeclampsia.3.Uric acid is a risk factor for the occurrence of preeclampsia,and the level of uric acid gradually increases with the increase of the severity of preeclampsia,which has certain predictive value for the occurrence of preeclampsia.4.In multivariate regression analysis,BMI,TC,TG,ApoA1,ApoB are the risk factors of preeclampsia;TC is a risk factor for the severity of preeclampsia.FFA has certain predictive value for the severity of preeclampsia,and its dynamic changes should be monitored.5.Compared with pre-eclampsia group and normal pregnancy group,patients with severe pre-eclampsia have a higher risk of premature infants and low birth weight infants.