Lipid Profile Pattern among Women Screened for Hyperglycaemia in Pregnancy at the University of Jos Teaching Hospital, Nigeria
Main Article Content
Keywords
Hyperglycaemia In Pregnancy, Dyslipidaemia, Lipids, Lipoproteins, Small Dense LDL Cholesterol
Abstract
Background: Hyperglycaemia in pregnancy (HIP) represents one of the most common medical challenges in pregnancy and the leading cause of adverse pregnancy outcomes the world over. Normal pregnancy is characterized by physiological adaptations such as progressive gestation-dependent increases in maternal triglycerides and total cholesterol which could be affected by insulin resistance, a common denominator affecting glucose and lipid metabolism. The study aimed to compare the patterns among pregnant women with HIP and those without HIP and determine the correlates of dyslipidaemia in pregnant women with HIP.
Methodology: This was a descriptive cross-sectional study. A total of 204 participants were recruited, made up of 65 women with HIP (cases) and 139 normoglycaemic women (controls). The data collected included demographics, anthropometric measurements, and medical history. Lipid profile assays were done using Roche Cobass C111 automated analyser (sdLDL was isolated using the Hirano method prior to analysis).
Results: The prevalence of HIP was found to be 31.7% among the study population. Dyslipidemia defined by LDL, TG, TC, HDL, and sdLDL was seen in 60%, 38.5%, 22.5%, 19%, and 30% respectively. Women with HIP had a slightly higher risk of dyslipidemia than normoglycaemic women. Overall, the difference in dyslipidemia between HIP and normoglcaemic women was not statistically significant.
Conclusion: Dyslipidemia in pregnancy is a relatively common finding in the Nigerian population. However, the pattern of dyslipidemia in normoglycaemic pregnant women is largely similar to the pattern seen in women with hyperglycaemia in pregnancy in the Nigerian population.
References
2. Nicolosi BF, Souza RT, Mayrink J, Feitosa FE, Rocha Filho EA, Leite DF, et al. Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study. Farias D, editor. PLoS One. 2020;15(5):e0232664.doi: 10.1371/journal.pone.0232664
4. Chodick G, Tenne Y, Barer Y, Shalev V, Elchalal U. Gestational diabetes and long-term risk for dyslipidemia: a population-based historical cohort study. BMJ Open Diabetes Res Care. 2020;8(1): :e000870. doi: 10.1136/bmjdrc-2019-000870.
5. Metzger BE. Long-term Outcomes in Mothers Diagnosed with Gestational Diabetes Mellitus and Their Offspring. Clin Obstet Gynecol. 2007;50(4):972–9.
6. Fuenzalida B, Sobrevia B, Cantin C, Carvajal L, Salsoso R, Gutiérrez J, et al. Maternal supraphysiological hypercholesterolemia associates with endothelial dysfunction of the placental microvasculature. Sci Rep. 2018;8(1):7690.
7. Ryckman K, Spracklen C, Smith C, Robinson J, Saftlas A. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015;122(5):643–51.
8. Schaefer-Graf UM, Meitzner K, Ortega-Senovilla H, Graf K, Vetter K, Abou-Dakn M, et al. Differences in the implications of maternal lipids on fetal metabolism and growth between gestational diabetes mellitus and control pregnancies. Diabet Med. 2011;28(9):1053–9.
9. Vani K. Alterations in lipid profile in gestational diabetes mellitus (GDM) and type 2 DM women during pregnancy. Int J Med Res Rev. 2015;3(8):800–4.
10. Diffenderfer MR, Schaefer EJ. The composition and metabolism of large and small LDL. Curr Opin Lipidol. 2014;25(3):221–6.
11. Zeljkovic A, Vekic J, Spasojevic-Kalimanovska V, Jelic-Ivanovic Z, Bogavac-Stanojevic N, Gulan B, et al. LDL and HDL subclasses in acute ischemic stroke: Prediction of risk and short-term mortality. Atherosclerosis 2010;210(2):548–54.
12. Leiva A, de Medina CD, Guzmn-Gutierrez E, Pardo F, Sobrevi L. Maternal Hypercholesterolemia in Gestational Diabetes and the Association with Placental Endothelial Dysfunction. [Internet] In: Gestational Diabetes - Causes, Diagnosis and Treatment. InTech; 2013. Available from: http://dx.doi.org/10.5772/55297
13. Liang N, Zhu H, Cai X, Le Z, Wang H, He D, et al. The high maternal TG level in early trimester was associated with the increased risk of LGA newborn in non-obesity pregnant women. Lipids Health Dis. 2018;17(1):294.
14. Anzaku AS, Musa J. Prevalence and associated risk factors for gestational diabetes in Jos, North-central, Nigeria. Arch Gynecol Obstet. 2013;287(5):859–63.
15. Imoh LC, Asorose SA, Odo AI, Aina DO, Abu AO, Ocheke AN. Modification of WHO diagnostic criteria for gestational diabetes: implications for classification of hyperglycemia in pregnancy. Int J Reprod Contraception Obst Gynaecol 2017;6(7):2716.
16. Atiba AS, Olofinbiyi BA, Akintunde AR, Peter AO, Clementinah OO, Ibikunle A. Maternal Plasma Lipid Profile in Women Screened for Gestational Diabetes Mellitus (GDM). Open J Obstet Gynecol. 2017;07(12):1209–15.
17. Hirano T, Ito Y, Saegusa H, Yoshino G. A novel and simple method for quantification of small, dense LDL. J Lipid Res.2003;44(11):2193–201.
18. Neboh E, Emeh J, Aniebue U, Ikekpeazu E, Maduka I, Ezeugwu F. Relationship between lipid and lipoprotein metabolism in trimesters of pregnancy in Nigerian women: Is pregnancy a risk factor? J Nat Sci Biol Med. 2012;3(1):32.
19. O’Malley EG, Reynolds CME, Killalea A, O’Kelly R, Sheehan SR, Turner MJ. Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM). Eur J Obstet Gynecol Reprod Biol. 2020; 246:67–71.
20. Expert Panel on Detection, Evaluation and T of HBC in A. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA J Am Med Assoc. 2001;285(19):2486–97.
21. Pusukuru R, Shenoi AS, Kyada PK, Ghodke B, Mehta V, Bhuta K, Bhatia A. Evaluation of Lipid Profile in Second and Third Trimester of Pregnancy. J Clin Diagn Res. 2016 Mar;10(3):QC12-6. doi: 10.7860/JCDR/2016/17598.7436
22. Onyenekwe BM, Young EE, Nwatu CB, Okafor CI, Ugwueze C V., Chukwu SN. Prevalence of Gestational Diabetes in South East Nigeria Using the Updated Diagnostic Guidelines. Dubai Diabetes Endocrinol J.2019;25(1–2):26–32.
23. Johns EC, Denison FC, Norman JE, Reynolds RM. Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends Endocrinol Metab. 2018;29(11):743–54.
24. Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM. Changes in Incidence of Diabetes in U.S. Adults, 1997–2003. Am J Prev Med. 2006;30(5):371–7.
25. Bomfim-Boaventura OC, Feitosa ACR. Prevalence of Dyslipidemia and Evaluation of the Influence of Body Composition, Physical Activity and Food Standard in the Serum Lipids of Low-Risk Pregnant Women: A Cross-Study. J Endocr Soc. 2021;5(Supp1): A296–7.
26. Yue S, Pei L, Chen W, Li Z, Xiao H, Li Z, et al. Dyslipidemia in Pregnancy and the Proper Reference Values: A Retrospective Study in South China. Obstet Gynecol Res. 2021;04(01).
27. Bartels A, Egan N, Khashan A, Joyce C, O’Mullane J, O’ Donoghue K. 228: Maternal cholesterol levels are elevated throughout normal pregnancy. Am J Obstet Gynecol. 2011;204(1):S98–9.
28. Cantin C, Fuenzalida B, Leiva A. Maternal hypercholesterolemia during pregnancy: Potential modulation of cholesterol transport through the human placenta and lipoprotein profile in maternal and neonatal circulation. Placenta. 2020; 94:26–33.
29. Goldberg AS, Hegele RA. Severe Hypertriglyceridemia in Pregnancy. J Clin Endocrinol Metab.2012;97(8):2589–96.
30. Mukherjee M. Dyslipidemia in Pregnancy - American College of Cardiology [Internet]. Available at:https://www.acc.org/Latest-in-Cardiology/Articles/2014/07/18/16/08/Dyslipidemia-in-Pregnancy. [accessed 10th June 2024]
31. Wang J, Li Z, Lin L. Maternal lipid profiles in women with and without gestational diabetes mellitus. Medicine (Baltimore). 2019 Apr;98(16):e15320. doi: 10.1097/MD.0000000000015320.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.