RESUMO
RESUMEN Fundamento: evidencias indican que las anormalidades del perfil lipídico contribuyen a la insulinorresistencia. Objetivo: determinar la relación entre los valores del perfil lipídico materno y la aparición de diabetes gestacional. Métodos: se realizó un estudio analítico, transversal con una muestra de 180 gestantes. Se les realizó colesterol total, triglicéridos, LDLc, HDLc y los índices LDLc/HDLc, triglicéridos/HDLc a todas las grávidas en dos momentos del embarazo: a la captación (≤ 12 semanas) y durante el tercer trimestre; así como PTG con 75 g de glucosa anhidra entre las 24-26 semanas de gestación, según el resultado de esta prueba el universo de estudio quedó dividido en dos grupos (con y sin diabetes gestacional). Se empleó estadística descriptiva e inferencial. Resultados: las medias de colesterol total y de triglicéridos se elevaron de manera significativa del primero al tercer trimestre del embarazo independientemente del estado de salud de las gestantes. En el análisis univariado las gestantes con diabetes mellitus gestacional tuvieron un incremento significativo de las concentraciones séricas de todos los componentes del perfil lipídico. El riesgo relativo de aparición de diabetes mellitus gestacional está estratificado según la evaluación nutricional de la gestante a la captación del embarazo donde es 1,46 veces mayor en la gestante obesa con cifras más altas de colesterol al inicio del embarazo y de 1,55 veces mayor en la que tiene valores mayores de triglicéridos. Conclusiones: aquellas embarazadas con mayores valores de triglicéridos, LDLc/HDLc o triglicéridos/HDLc a la captación tuvieron mayor riesgo de desarrollar diabetes gestacional.
ABSTRACT Background: searchers had shown that abnormalities on maternal lipid profile due to resistance to insulin. ` Objective: to evaluate the relationship between maternal lipid profile and the development of gestational diabetes mellitus. Methods: an analytic, cross-sectional, study was carried out with a sample of 180 pregnant women. Total cholesterol, triglycerides, LDLc, HDLc, LDLc/HDLc and triglycerides/HDLc were done to all pregnant women in two moments: at the begin of the pregnancy (less than 12 weeks) and during the third trimester; glucose tolerance test with 75 grams of anhydrate glucose between 24-26 weeks was done too, according to its results the sample was divided in two groups: healthy pregnant women and pregnant women with gestational diabetes mellitus. Inferential and descriptive statistics were used. Results: main values of total cholesterol and triglycerides increases the first trimester to third trimester, regardless the health state of the pregnant women. Pregnant women who suffer from gestational diabetes mellitus had increases of all parameters on lipid profile. Odds Ratio for the development of gestational diabetes mellitus was 1.46 times higher on obese pregnant women with high cholesterol and 1.55 times higher on obese pregnant women with high triglycerides. Conclusions: pregnant women who had high levels of triglycerides, LDLc/HDLc or triglycerides/HDLc at the beginning of pregnancy had more risk of developing gestational diabetes.
RESUMO
Objective To describe the work of quality control for lipids measurement in CNHS 2002.Methods The quality control was applied over the whole project including staff training,making standard operating procedure(blood collection,separation,temporary storage,transportation,final storage),lab materials assignment,internal quality control in central lab and participating US Disease Control Center's Lipids Standard Program(LSP)as external quality control.Results Seven times of national training programs were held and 326 technicians from CDCs in 31 provinces,autonomous regions, municiplalities and 132 surveyed counties received related trainings.During the program,321 persons passed examination (98.5%)and among them 205 got the A score(62.9%);The field work was implemented strictly according to the procedure. Three automatic biochemical instruments were used in the measurement and there is no significant difference between means of serum TC,TG and HDL-C from several batches of quality control serum.Parallel measurements were conducted in five percent randomly selected samples,the ratio of bias less than 3% was 99.05%,96.40% and 98.30% for TC,TG and HLD-C, respectively.Compared with means of LSP control sera,the results showed that all bias was less than 5% except one bias of TG result(7.02%)in one batch of LSP controls.Conclusion The work of quality control in this survey guaranteed the accuracy of plasma lipids measurement,and provided the basic data for the epidemiological description of dyslipidemia status among Chinese and the further analysis.