PREVALENCE OF MATERNAL SUPRAPHYSIOLOGICAL DYSLIPIDEMIA IN A GROUP OF CHILEAN PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS

Abstract

During pregnancy mothers exhibits a physiological dyslipidemia characterized by elevated plasma level of total cholesterol (TC) and triglycerides (Tg), referred as maternal physiological dyslipidemia (MPD). Some pregnancies develop a supraphysiological dyslipidemia (MSPD), which associates with fetoplacental endothelial dysfunction. Gestational diabetes mellitus (GDM) is a pregnancy disease with maternal and fetal hyperglycemia leading to fetoplacental endothelial dysfunction. Although is described that GDM also associates with maternal dyslipidemia, the prevalence of MSPD in GDM pregnancies or the effect of this condition on the fetal vasculature are unknown. Objective: To determine the prevalence of MSPD in a group of GDM pregnancies.127 Methods: Prevalence of GDM was estimated in 4732 Chilean pregnant women from the Hospital Clínico UC-CHRISTUS (Santiago, Chile) for the period 2014-2015. Maternal lipids were determined in trimesters 1 (T1), 2 (T2), and 3 (T3) of pregnancy to estimate MSPD prevalence. Pregnancies with TC >280 mg/dL and Tg >275 mg/dL were considered as MSPD. Results: The prevalence of GDM was 7.2%, of which a 25.2% showed with MSPD. TC (T1: 173 ± 23 vs 232 ± 17, T2: 206 ± 35 vs 285 ± 15, T3: 226 ± 35 vs 310 ± 25 mg/dL) and Tg (T1: 99 ± 22 vs 203 ± 57, T2: 155 ± 36 vs 250 ± 58, T3: 195 ± 52 vs 349 ± 65 mg/dL) were increased (P<0.05) in all the trimesters of pregnancy in GDM with MSPD compared to MPD. Conclusions: A significant number of GDM pregnancies present with MSPD in the studied population with increased TC and Tg. Although the consequences of this phenomenon are unknown, it could contribute to the fetoplacental vascular alterations described in MSPD. Funding: FONDECYT 1150344/1150377, BF holds VRI/Faculty of Medicine (PUC) PhD fellowship. http://dx.doi.org/10.1016/j.placenta.2017.01.096