ASSOCIATION OF LIPID LEVELS DURING GESTATION WITH PREECLAMPSIA AND GESTATIONAL DIABETES MELLITUS: THE POTENTIAL ROLE OF STATINS

Main Article Content

Dr Chaman Ara
Dr Sara Yar Khan
Dr Sheherbano Yahya
Dr Umair Wadood
Dr Shahnaz Fatima
Dr Sofia Irshad

Keywords

Gestational diabetes mellitus, Preeclampsia, Dyslipidaemia, Statin

Abstract

Background: Gestational diabetes mellitus (GDM) and preeclampsia are two main pregnancy disorders that carry a high danger to the health of both the mother and the foetus. After 20 weeks of pregnancy, preeclampsia, which presents as hypertension and proteinuria, can cause major consequences for the mother, including eclampsia, organ malfunction, heart failure, foetal growth restriction, and premature birth.


Objective: To explore the relationship between preeclampsia and gestational diabetes mellitus (GDM) incidence and lipid levels throughout gestation.


Methodology: The DHQ Teaching Hospital in Abbottabad served as the study site for this retrospective cohort study. The time frame for the investigation was March 2022–March 2023. The study comprised of 181 pregnant women who delivered at DHQ Teaching Hospital Abbottabad during the study period.


Results: Our investigation included 181 pregnant participants who developed preeclampsia and GDM had high mean levels of ‘total cholesterol, LDL-C, and triglycerides, and lower HDL-C’ compared to those who did not. Raise in ‘total cholesterol, LDL-C, and triglycerides’ were associated with high risks of preeclampsia and GDM, while high HDL-C levels were protective. Additionally, statin use was associated with a lower incidence of preeclampsia.


Conclusion: Our results show a ‘significant association between’ high cholesterol levels and ‘increased risk of preeclampsia’ and gestational diabetes mellitus during pregnancy. Three parameters of ‘lipids i-e total levels of cholesterol, LDL-C, and triglycerides’ were associated with increased risk in both conditions while there was a protective response of high HDL-C. There was no statistical significance observed between use of statin and the occurrence of preeclampsia and GDM (due to the smaller sample size of statin group), statin can overall reduce the incidence of both conditions in pregnancy.

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References

1. Lewandowska M, Więckowska B, Sajdak S. Pre-pregnancy obesity, excessive gestational weight gain, and the risk of pregnancy-induced hypertension and gestational diabetes mellitus. Journal of clinical medicine. 2020 Jun 24;9(6):1980.
2. Bartal MF, Lindheimer MD, Sibai BM. Proteinuria during pregnancy: definition, pathophysiology, methodology, and clinical significance. American journal of obstetrics and gynecology. 2022 Feb 1;226(2):S819-34.
3. Zeljković A, Ardalić D, Vekić J, Antonić T, Vladimirov S, Rizzo M, Gojković T, Ivanišević J, Mihajlović M, Vujčić S, Cabunac P. Effects of Gestational Diabetes Mellitus on Cholesterol Metabolism in Women with High-Risk Pregnancies: Possible Implications for Neonatal Outcome. Metabolites. 2022 Oct 11;12(10):959.
4. Pham A, Polic A, Nguyen L, Thompson JL. Statins in Pregnancy: Can We Justify Early Treatment of Reproductive Aged Women?. Current Atherosclerosis Reports. 2022 Aug;24(8):663-70.
5. McKiever M, Frey H, Costantine MM. Challenges in conducting clinical research studies in pregnant women. Journal of pharmacokinetics and pharmacodynamics. 2020 Aug;47:287-93.
6. Karalis DG, Hill AN, Clifton S, Wild RA. The risks of statin use in pregnancy: a systematic review. Journal of clinical lipidology. 2016 Sep 1;10(5):1081-90.
7. Lewek J, Bielecka-Dąbrowa A, Toth PP, Banach M. Dyslipidemia management in pregnant patients: a 2024 update. European Heart Journal Open. 2024 Apr 26:oeae032.
8. Konrad E, Güralp O, Shaalan W, Elzarkaa AA, Moftah R, Alemam D, Malik E, Soliman AA. Correlation of elevated levels of lipoprotein (a), high-density lipoprotein and low-density lipoprotein with severity of preeclampsia: a prospective longitudinal study. Journal of Obstetrics and Gynaecology. 2020 Jan 2;40(1):53-8.
9. Hu J, Gillies CL, Lin S, Stewart ZA, Melford SE, Abrams KR, Baker PN, Khunti K, Tan BK. Association of maternal lipid profile and gestational diabetes mellitus: A systematic review and meta-analysis of 292 studies and 97,880 women. EClinicalMedicine. 2021 Apr 1;34.
10. Tesfa E, Nibret E, Munshea A. Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis. Plos one. 2020 Dec 23;15(12):e0243538.
11. Zhu H, He D, Liang N, Lai A, Zeng J, Yu H. High serum triglyceride levels in the early first trimester of pregnancy are associated with gestational diabetes mellitus: a prospective cohort study. Journal of Diabetes Investigation. 2020 Nov;11(6):1635-42.
12. Li F, Hu Y, Zeng J, Zheng L, Ye P, Wei D, Chen D. Analysis of risk factors related to gestational diabetes mellitus. Taiwanese Journal of Obstetrics and Gynecology. 2020 Sep 1;59(5):718-22.
13. Rao SJ, Martin SS, Lawson SM, Hailu T, Davis DM, Nasir K, Cainzos-Achirica M, Blumenthal RS, Sharma G. Evaluating the role of statins in prevention of preeclampsia: deeper insights into maternal cardiometabolic changes. Journal of Clinical Lipidology. 2022 Jul 1;16(4):403-16.
14. Stanirowski PJ, Wątroba M, Pyzlak M, Wejman J, Szukiewicz D. Expression of placental lipid transporters in pregnancies complicated by gestational and type 1 diabetes mellitus. International Journal of Molecular Sciences. 2024 Mar 21;25(6):3559.
15. Ardalić D, Stefanović A, Banjac G, Cabunac P, Miljković M, Mandić-Marković V, Stanimirović S, Pažin BD, Spasić S, Spasojević-Kalimanovska V, Karadžov-Orlić N. Lipid profile and lipid oxidative modification parameters in the first trimester of high-risk pregnancies-possibilities for preeclampsia prediction. Clinical Biochemistry. 2020 Jul 1;81:34-40.