Changes and clinical significance of body mass index, blood lipid and fat soluble vitamin levels in patients with different types of severe preeclampsia / 中国基层医药

ABSTRACT

Objective:To investigate the changes and clinical significance of body mass index (BMI), blood lipid and fat soluble vitamin levels in patients with different types of severe preeclampsia.Methods:Sixty-eight pregnant women with severe preeclampsia who received antenatal examination in Lishui Maternal and Child Health Care Hospital, China from February 2017 to February 2019 were included in the study group. According to the onset time, the pregnant women were divided into an early onset group (≤ 34 weeks of gestation, n = 38) and a late onset group (> 34 weeks of gestation, n = 30). An additional 50 healthy pregnant women who concurrently received antenatal examination in the same hospital were included in the control group. Serum levels of triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), vitamin A (VA), vitamin E (VE) and vitamin D 3 (VD 3) were determined in all pregnant women. Logistic regression was used to analyze severe preeclampsia-related influential factors. Results:There were no significant differences in age, number of births and number of pregnancies among the three groups (all P > 0.05). BMI and serum levels of VA, VE, TC, TG, and LDL-C were (22.99 ± 4.39) kg/m 2, (0.48 ± 0.08) ng/mL, (11.91 ± 1.74) ng/mL, (4.93 ± 0.34) mmol/L, (1.57 ± 0.26) mmol/L, (2.68 ± 0.27) mmol/L, respectively, which were significantly higher than those in the control group [(20.68 ± 3.68) kg/m 2, (0.40 ± 0.07) ng/mL, (10.32 ± 2.56) ng/mL, (4.12 ± 0.67) mmol/L, (1.25 ± 0.32) mmol/L, (2.15 ± 0.32) mmol/L, t = 3.725, 6.698, 4.352, 8.731, 6.282, 10.512, all P < 0.05]. Serum levels of HDL-C and VD 3 in the study group were (1.51± 0.32) mmol/L and (16.16 ± 2.37) ng/mL, respectively, which were significantly lower than those in the control group [(1.88 ± 0.57) mmol/L, (17.86 ± 2.39) ng/mL, t = - 6.959, - 4.520, both P < 0.05]. BMI and serum levels of TC, TG, LDL-C, VA and VE in the early onset group were (23.13 ± 4.13) kg/m 2, (5.05 ± 0.34) mmol/L, (1.62 ± 0.27) mmol/L, (2.95 ± 0.32) mmol/L, (0.52 ± 0.06) ng/mL, (12.16 ± 1.80) ng/mL, respectively, which were significantly higher than those in the control group ( t = 6.507, 17.462, 11.217, 16.593, 9.075 and 4.142, all P < 0.05). Serum levels of HDL-C and VD 3 in the early onset group were (1.43 ± 0.28) mmol/L and (15.76 ± 2.42) ng/mL, respectively, which were significantly lower than those in the control group ( t = 14.635, 5.871, both P < 0.05). BMI and serum levels of TC, TG and VE in the late onset group were (22.70 ± 4.32) kg/m 2, (4.67±0.32) mmol/L, (1.49 ± 0.25) mmol/L and (11.45 ± 1.61) ng/mL, respectively, which were significantly higher than those in the control group ( t = 5.821, 12.857, 8.059, 3.482, all P < 0.05). Serum level of VD3 in the late onset group was (16.72 ± 2.31) ng/mL, which was significantly lower than that in the control group ( t = 4.319, P = 0.01). There were no significant differences in serum levels of LDL-C, HDL-C and VA between late onset group and control group (all P > 0.05). There were no significant differences in BMI, and serum levels of TC, TG, HDL-C, LDL-C, VA, VD 3 and VE between early onset and late onset groups (all P > 0.05). Logistic regression analysis results revealed that BMI and serum levels of TG, TC, HDL-C, LDL-C, VA, VD 3 and VE are independent influential actors of early onset severe preeclampsia ( P = 0.000, 0.008, 0.032, 0.043, 0.032, 0.002, 0.041, 0.009). BMI and serum levels of TG, TC, VD 3 and VE are independent influential actors of late onset severe preeclampsia ( P = 0.002, 0.016, 0.013, 0.031, 0.042). BMI, blood lipid and fat soluble vitamin in combination are of high value for the prediction of early onset severe preeclampsia (sensitivity 87.81% and specificity 76.67%), but they are not of high value for the prediction of late onset severe preeclampsia (sensitivity 52.51% and specificity 55.10%). Conclusion:BMI, serum lipid and fat soluble vitamin in combination are of high value in the prediction of early-onset severe preeclampsia.