1. L. Bozkurt1, C. S. Göbl2 , A.-T. Hörmayer1, Anton Luger1, Sabina Baumgartner-Parzer1, A. Kautzky-Willer1
Implications of pregestational overweight and obesity on the lipid and glucometabolic profile during pregnancy
Introduction:
Lipid alterations during gestation are suggested to impact obesity and GDM associated adverse pregnancy outcomes. The objective is to assess longitudinal changes in serum lipids during pregnancy in women with different degrees of obesity under special consideration of the glucometabolic status.
Methods:
208 pregnant women stratified by preconceptional BMI (normal weight with BMI<25: n=89 (42,8%), overweight with BMI : n=59 (28.4%), obese with BMI>30: n=60 (28.8%)) underwent an 75g-2h-OGTT ≤21st gestational week (visit 1). Final diagnosis was performed in gestational week (IADPSG criteria: 129 NGT, 79 GDM). An additional blood drawn for the assessment of glucometabolic and lipid profile was performed in visit 1 and at further three visits until delivery. OGTT data were used to estimate insulin sensitivity.
Results:
GDM prevalence was related to degree of obesity (normal weight: 25.8%, overweight: 40.7%, obese: 53.3%, p=0.003). At baseline obese and overweight women showed already elevated levels of triglycerides (TG, p<0.001) and usCRP (p<0.001) and decreased HDL-C values (p=0.01), whereas total cholesterol (TC) and LDL-C were comparable between the groups. In relation to visit 1 all lipid parameters showed a significant increase in the whole group. However, the increase in serum lipid concentrations was less pronounced in overweight and obese compared to normal weight subjects (LDL-C: p=0.006, TC: p=0.002, TG: p=0.002). These differences were independent of baseline insulin resistance and GDM status. Regarding fetal outcome maternal obesity was associated with higher birth weight (percentiles of gestational age). Although lipids were not correlated to birth weight there was a significant association with preconceptional BMI and insulin resistance during pregnancy.
Conclusion:
Decrease of pregnancy induced hyperlipidemia in obese and overweight women is independently prevalent of glucose disorders. Further studies on the effect of maternal metabolism on fetal outcome is needed.
Figure 2: Trajectories of LDL-C as well as total cholesterol from the beginning of pregnancy (≤21st gestational week) until delivery in subjects divided by degree of obesity (normal weight=BMI<25, overweight=BMI , obese=BMI>30)
(1)Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna , Vienna
(2)Department of Gynecology and Obstetrics, Division of Feto-Maternal Medicine, Medical University of Vienna , Vienna
DIP 2015