JCEM:正常妊娠和子痫前期孕产妇脂肪和能量平衡的变化

2021-04-09 MedSci原创 MedSci原创

与正常妊娠相比,子痫前期后的产后阶段,胰岛素抵抗和FM%增加,高密度脂蛋白降低,以及生活方式以久坐为主要特征。

子痫前期是一种主要的妊娠并发症,与孕产妇长期心脏代谢性疾病相关。大多数研究主要关注妊娠期间的代谢和病理生理变化,但对子痫前期患者产后早期的关注较少。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,这项研究旨在归纳(a)正常血压和子痫前期妊娠6个月后的能量摄入和消耗,(b)评估能量平衡、身体成分、胰岛素抵抗指标(HOMA-IR)与临床特征之间的关系。

研究人员对正常血压(n=75)和子痫前期(n=22)孕妇产后六个月进行了横断面研究。代谢指标包括:人体测量学指标、通过生物电阻抗分析的身体组成、通过SenseWear臂带测定的24小时能量消耗、通过三天食物日记确定的能量摄入以及血清代谢参数。

与血压正常的女性相比,子痫前期女性6个月内体重(77.3±20.9kg vs. 64.5±11.4kg, p=0.01)、脂肪质量百分比(FM%,40.7±7.4% vs. 34.9±8.1%,p=0.004)、胰岛素抵抗(HOMA-IR 2.2±1.5 vs. 1.0±0.7,p=0.003)、高密度脂蛋白水平(1.5±0.4 mmol/L vs. 1.8±0.4 mmol/L, p=0.01)显著升高。与正常血压的患者相比,子痫前期患者的活动相关能量消耗较低(p=0.02),但总能量摄入减少(p=0.02),导致了更负的能量平衡(-1942 kJ/24小时 vs. -480 kJ/24小时,p=0.02)。

由此可见,与正常妊娠相比,子痫前期后的产后阶段,胰岛素抵抗和FM%增加,高密度脂蛋白降低,以及生活方式以久坐为主要特征。应实施和评估早期的子痫前期干预措施,如改变生活方式行为,以确定它们是否降低妊娠期间经历过子痫前期妇女的长期心脏代谢风险。

原始出处:

Sarah L McLennan.et al.Maternal adiposity and energy balance after normotensive and preeclamptic pregnancies.JCEM.2021.https://doi.org/10.1210/clinem/dgab223

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    2021-11-24 smallant2015
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    2022-01-30 achengzhao
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    2021-04-09 肝胆想招

    很好

    0

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    2021-04-11 yahu
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