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Metabolism:先兆子痫和子痫对孕产妇代谢和生化结果的影响

2019-11-20 xing.T MedSci原创

在中长期随访中,PE/E妇女的代谢和生化特征比没有PE/E的妇女更差。

近日,代谢性疾病领域权威杂志Metabolism-Clinical and Experimental上发表了一篇研究文章,研究人员旨在评估先兆子痫(PE)和子痫(E)与后续代谢和生化结果之间的关联性。

研究人员对观察性研究进行了系统评价和荟萃分析,共检索了五个数据库,截止至2018年11月,以评估PE/E对分娩后新陈代谢和生化结果的影响。PE被定义为妊娠>20周时出现高血压和蛋白尿。对照者没有PE/E。该分析的主要结果是血压(BP)、体重指数(BMI)、代谢综合征(MetS)、血脂和血糖水平。随机效应模型用于荟萃分析,效应报告为风险差异(RD)或均数差异(MD)及其95%置信区间(CI)。

研究人员评估了41个队列,包含3300例PE/E和13967例血压正常对照者。从分娩后3个月至产后32年对妇女进行随访。与对照者相比,PE/E可显著增加收缩压(MD=8.3mmHg,95%CI为6.8至9.7)、舒张压(MD=6.8mmHg,95%CI为5.6-8.0)、BMI(MD=2.0 kg/m2 ; 95%CI为1.6-2.4)、腰围(MD=4.3cm,95%CI为3.1-5.5)、腰臀比(MD=0.02,95%CI为 0.01-0.03)、体重(MD=5.1 kg,95%CI为2.2-7.9)、总胆固醇(MD=4.6 mg/dL,95%CI为1.5-7.7)、LDL(MD=4.6 mg/dL; 95%CI为0.2-8.9)、甘油三酸酯(MD=7.7 mg/dL, 95%CI为3.6至11.7)、血糖(MD=2.6 mg/dL,95%CI为1.2至4.0)、胰岛素(MD=19.1 pmol/L,95%CI为11.9-26.2)、HOMA-IR指数(MD=0.7,95%CI为0.2-1.2)、C反应蛋白(MD=0.05 mg/dL,95%CI为0.01-0.09)、高血压(RD=0.24、95%CI为 0.15-0.33)和MetS(RD=0.11,95%CI为0.08-0.15)风险。而且,PE/E降低了HDL水平(MD=-2.15mg/dL,95%CI为3.43.46至-0.85)。大多数结果的异质性很高。跨研究的偏倚风险中等。亚组分析显示出与主要分析相似的结果。

在中长期随访中,PE/E妇女的代谢和生化特征比没有PE/E的妇女更差。 

原始出处:

Vanesa Alonso-Ventura,et al.Effects of preeclampsia and eclampsia on maternal metabolic and biochemical outcomes in later life: a systematic review and meta-analysis.Metabolism-Clinical and Experimental.2019.https://doi.org/10.1016/j.metabol.2019.154012

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    2019-12-18 hb2008ye
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    2020-02-19 一闲
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    2019-11-22 闆锋旦

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