Association of pre-pregnancy subclinical insulin resistance with cardiac dysfunction in healthy nulliparous women

Subclinical Metabolic and Cardiovascular Factors and Brain White Matter Microstructural Integrity in Young Women

Women who have experienced pregnancy complications, specifically preeclampsia and gestational diabetes, have well documented increased risks of cardiovascular, metabolic, and neurological disease later in life. This study examined how specific cardiovascular and metabolic risk factors for preeclampsia assessed in a non-pregnant state were associated with brain white matter microstructural integrity. This study examined sixty-two healthy women (mean age 31 ± 5 years) who received metabolic and cardiovascular assessments as well as multiple modality MRI imaging. Participants were either nulliparous (n = 31) or had a history of preterm preeclampsia (n = 31). Imaging included acquisition Diffusion Tensor Imaging (DTI) to assess white matter integrity within the brain. We hypothesized that healthy, young, non-pregnant women with cardiovascular and metabolic profiles suggesting elevated risk would have decreased white matter integrity, represented by lower Fractional Anisotropy (FA) and increased Mean Diffusivity (MD) estimates in the posterior cortical areas of the brain. We observed increased white matter degradation (lower FA and increased MD) in posterior and occipital tracts, commissural fibers, and subcortical structures in women with increased adiposity, worse measures of cardiovascular and metabolic function, including greater insulin resistance (HOMA-IR), hyperlipidemia, elevated blood pressure, and increased arterial stiffness. The relationships detected between subclinical cardiovascular and metabolic phenotypes and increased white matter disruption at a young age, outside of pregnancy, are indicative that adverse changes are detectable long before cognitive clinical presentation. This may suggest that many of the long-term cardiovascular and metabolic risks of aging are influenced by physiologic aging trajectories rather than damage caused by pregnancy complications.

A Meta-Analysis of the Differences in Serum Lipid Levels between Pregnant Women with Hypertensive Disorder Complicating Pregnancy and Nonhypertensive Disorder Complicating Pregnancy

Background

Although a lot of research work has been done on the etiology and pathogenesis of hypertensive disorder complicating pregnancy at home and abroad, the exact etiology and pathogenesis of the disease are still uncertain so far.

Aims

Systematic review of meta-analysis of differences in serum lipid levels between pregnant women with hypertensive disease complicated with pregnancy and nonhypertensive disease complicated with pregnancy.

Materials and Methods

PubMed, Medline, Embase, Science Citation Index (SCI), Cochrane, Springer, CNKI, Wanfang, VIP, and other databases were used to retrieve published literature and evaluate the included literature according to the quality evaluation method of medical literature introduced by the Cochrane Collaboration. A systematic review of the included studies was performed by meta-analysis.

Results

We included 9 articles that documented total bile acids and D-dimers. In the heterogeneity test (P < 0.05, I 2 = 100% > 50%), it was considered that the study was heterogeneous, so sensitivity analysis was used, the fixed-effect model was replaced, and the results were not significantly different after each item was excluded. Reliably, the difference was statistically significant (Z = 7.32, P < 0.001). In the TG metaheterogeneity test,P < 0.05,I 2 = 99% > 50%, to explore the source of heterogeneity and conduct sensitivity analysis and switch to fixed-effect model, the difference was not statistically significant (P > 0.05). There was no significant difference in TC between hypertensive disorder complicating pregnancy and nonhypertensive disorder complicating pregnancy (P > 0.001).

Conclusion

D-dimer, total bile acids, and glycopyrrolate were highly expressed in the sera of pregnant women with hypertensive disorder complicating pregnancy dyslipidemia.