Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

Dyslipidaemia-related cardiovascular risk among pregnant women attending Aminu Kano Teaching Hospital Kano: A longitudinal study

OBJECTIVE

Maternal dyslipidaemia and atherogenic lipid profiles have undesirable effects on maternal and foetal well-being throughout gestation. This study investigates the changes in serum lipid profiles, the prevalence of dyslipidaemia, and the risk of cardiovascular disease among pregnant women attending the antenatal care unit of the Aminu Kano Teaching Hospital (AKTH), Kano.

METHODS

A total of 112 pregnant women visiting AKTH in their second trimester were recruited and followed up within their third trimester. The demographic characteristics, daily dietary consumption patterns, and lipid profiles of all women were assessed using standard methods.

RESULTS

The results revealed that the mean age and gestational age of the pregnant women were approximately 29 ± 6 years and 20 ± 3 weeks, respectively. Most pregnant women were multiparous (76) and multigravida (93). Regarding daily dietary consumption patterns, 20.5%, 63.4%, 13.4%, and 8.0% of the pregnant women consumed nuts, palm oil, butter, and sardines at least one to three times, respectively. Moreover, the serum lipid profiles revealed that the prevalence of dyslipidaemia, hypercholesterolaemia, hypertriglyceridaemia, increased low-density lipoprotein levels, and decreased high-density lipoprotein levels among pregnant women during the second trimester were 69.6%, 19.6%, 36.6%, 18.8%, and 49.1%, respectively. All these parameters significantly increased to 91.8%, 54.1%, 75.3%, 40.0%, and 62.4%, respectively, in the third trimester. Pregnant women showed a high risk of cardiovascular disease in both the second (81.0%) and third (85.0%) trimesters.

CONCLUSION

Progression from mid-pregnancy to delivery is associated with an increased risk of maternal dyslipidaemia and cardiovascular diseases among pregnant women.

Influence of Dietary Behaviors on Dyslipidemia in Pregnant Women and Its Effects on Physical Development of Fetuses and Infants: A Bidirectional Cohort Study

BACKGROUND

Gestational diabetes can alter the trajectory of fetal development, but there are few studies on the effects of abnormal lipid metabolism on physical development of infants. We aimed to explore the prevalence of maternal dyslipidemia, its influencing factors and effects on the physical development of fetuses and infants, as well as the role of leptin in this process.

METHODS

Questionnaire surveys and main outcome measures were administered among 338 pairs of pregnant women and newborns.

RESULTS

The detection rate of maternal dyslipidemia was 31.5%. The median levels of TG (triglyceride) and TG/HDL (high-density lipoprotein) ratio were higher in large-for-gestational-age (LGA) newborns. Birth weight was positively related to infants' height and weight at six months and one year old (p < 0.05). Leptin was positively related to TG levels of pregnant women and newborns' birth weight (p < 0.05). Logistic regression analysis showed that having greater than or equal to four meals a day (OR = 6.552, 95%CI = 1.014-42.338) and liking to eat lightly flavored food during pregnancy (OR = 1.887, 95%CI = 1.048-3.395) were independent risk factors of maternal dyslipidemia.

CONCLUSIONS

The prevalence of dyslipidemia was relatively high in pregnant women and was affected by dietary behaviors. Abnormal lipid levels during pregnancy could affect weight and length at birth, which might be associated with increasing leptin levels in cord blood, and then the weight of infants would be influenced by birth weight.

Prevalence and predictors of dyslipidemia among hypertensive patients in Lumame Primary Hospital, Amhara, Ethiopia: A cross-sectional study

BACKGROUND

Serum lipid profile abnormalities are major predictors for coronary artery diseases. The relationship between demographic factors and dyslipidemia in Ethiopia is not completely explored. Thus, this study aimed to assess the prevalence and predictors of dyslipidemia among hypertensive patients in Lumame Primary Hospital.

METHODS

A cross-sectional study was conducted from June to August 30, 2020, on the hypertensive patients in Lumame Primary Hospital. All adult hypertensive patients who visited the adult hypertensive care services during the study period were included. Interview-guided self-administered questionnaire and a chart review were used for data collection. Statistical Package for the Social Sciences (SPSS) software version 24.0 was used for data analysis.

RESULTS

Out of 372 hypertensive patients, 190(51.1%) were females and the mean age of the study participants was 43.56 years (SD ± 4.31). The overall prevalence of dyslipidemia in this study was 48.4%. Besides the overall prevalence, the prevalence of TC, TG, LDL-c, and HDL-c was 73(19.6%), 91(24.5%), 60(16.1%), and 115(30.9%), respectively. Females were at higher risk for having high levels of TC (AOR = 2.31, 95% CI = 1.54-3.13), TG (AOR = 1.70, 95% CI = 1.34-3.79), LDL-c (AOR = 2.15, 95% CI = 1.56-2.86), and HDL-c (AOR = 2.67, 95% CI = 1.44-5.67) than males. Respondents who were from urban were at higher risk for having high levels of TC (AOR = 1.98, 95% CI = 1.04-6.83), TG (AOR = 1.78, 95% CI = 1.09-2.86), LDL-c (AOR = 3.01, 95% CI = 1.45-7.43), and HDL-c (AOR = 2.01, 95% CI = 1.94-4.55) than respondents who were from rural. Similarly, obese respondents were at higher risk for having high levels of TC (AOR = 2.03, 95% CI = 1.64-2.00), TG (AOR = 3.78, 95% CI = 1.06-6.42), LDL-c (AOR = 1.92, 95% CI = 1.66-2.12), and HDL-c (AOR = 4.23, 95% CI = 2.84-4.32) than to respondents who were underweight.

CONCLUSION

The prevalence of dyslipidemia among hypertensive patients was high. Independent variables such as age, gender, residence, family history of HTN, smoking, alcohol drinking, fruit diet habits, physical activity, DM, and BMI were significant determinants of dyslipidemia.

Posterior Blepharitis and Associated Potential Factors: A Study among Pregnant Women

Purpose: This study evaluates in a cross-section of pregnant women the frequency of posterior blepharitis, its predisposing factors and how lipid profile impacts the occurrence of posterior blepharitis in pregnancy.Methods: This was a hospital-based cross-sectional study of pregnant women.Results: In this study, 201 pregnant women were recruited and included in the study's analysis. The participants' mean age was 29.96 (±4.74) years, with a median age of 30 and a range of 17 to 40 years. The frequency of posterior blepharitis among this cohort was 13.4% (95% confidence interval, 9.0% to 18.4%). The frequencies of MGD-associated posterior blepharitis and non-MGD associated posterior blepharitis were 6.0% and 7.4%, respectively. There was no statistically significant difference in the mean fluorescein tear breakup time and SPEED scores between non-MGD associated posterior blepharitis and MGD-associated posterior blepharitis, however, the mean tear breakup time(t = 3.999, p < .001) and SPEED scores (t = 6.76, p < .0001) showed a statistically significant difference in posterior blepharitis pregnant women compared to non-posterior blepharitis pregnant women. There was a statistically significant difference in the mean corneal staining scores between non-MGD-associated posterior blepharitis and MGD-associated posterior blepharitis (t = 3.99, p = .001). There was no association between lipid profile and posterior blepharitis in binary logistic regression analysisConclusion: The study showed that posterior blepharitis occurs in pregnancy, but it is not associated with cholesterol levels.

Prevalence of dyslipidemia and associated risk factors among adult residents of Mekelle City, Northern Ethiopia

Introduction

Dyslipidemia is a major risk factor for cardiovascular diseases (CVD). The prevalence of dyslipidemia is not known among Ethiopian adults. The prevalence is expected to rise due to the socio-economic development accompanied by lifestyle changes. This study was conducted to estimate the prevalence of dyslipidemia and associated risk factors among adult residents of Mekelle City.

Methods

A community-based cross-sectional study was conducted among 321 randomly selected subjects. Data were collected on sociodemographic, anthropometric, lifestyle, and clinical characteristics of the participants using the WHO STEPS survey instrument. Data were analyzed using SPSS software version 24.0. Student’s t-test and Pearson’s Chi-square test were used to assessing the interrelationship between each factor and outcome variables. Bivariate and multivariable logistic regression analysis were used to identify risk factors associated with dyslipidemia. All statistical significance was considered at p ≤0.05.

Results

The prevalence of dyslipidemia in this study was 66.7%. The prevalence of high low-density lipoprotein cholesterol (LDL-C), elevated triglyceride, elevated total cholesterol, and low high-density lipoprotein cholesterol (HDL-C) was 49.5%, 40.2%, 30.8%, and 16.5%, respectively. Being above 64 years (aOR: 2.196, 95% CI: 1.183–4.078) and 40–64 years old (aOR: 2.196, 95% CI: 1.183–4.078), overweight (aOR: 2.50, 95% CI: 1.314–4.756) and obesity (aOR: 15.489, 95% CI: 3.525–68.070), walking <150 minutes per week (aOR: 1.722, 95% CI: 1.004–2.953), raised fasting blood glucose (FBG) (aOR: 4.804, 95% CI: 1.925–11.988), and medium socio-economic status (aOR: 2.017, 95% CI: 1.044–3.899) were identified as significant predictors of dyslipidemia.

Conclusions

The finding of this study indicated that the prevalence of dyslipidemia is unacceptably high among adult residents of Mekelle City, which underlines an urgent need for early detection and public health interventions through the integrated involvement of public, governmental, and non-governmental organizations.

Excessive early-life cholesterol exposure may have later-life consequences for nonalcoholic fatty liver disease

The in utero and immediate postnatal environments are recognized as critical windows of developmental plasticity where offspring are highly susceptible to changes in the maternal metabolic milieu. Maternal hypercholesterolemia (MHC) is a pathological condition characterized by an exaggerated rise in maternal serum cholesterol during pregnancy which can program metabolic dysfunction in offspring, including dysregulation of hepatic lipid metabolism. Although there is currently no established reference range MHC, a loosely defined cutoff point for total cholesterol >280 mg/dL in the third trimester has been suggested. There are several unanswered questions regarding this condition particularly with regard to how the timing of cholesterol exposure influences hepatic lipid dysfunction and the mechanisms through which these adaptations manifest in adulthood. Gestational hypercholesterolemia increased fetal hepatic lipid concentrations and altered lipid regulatory mRNA and protein content. These early changes in hepatic lipid metabolism are evident in the postweaning environment and persist into adulthood. Further, changes to hepatic epigenetic signatures including microRNA (miR) and DNA methylation are observed in utero, at weaning, and are evident in adult offspring. In conclusion, early exposure to cholesterol during critical developmental periods can predispose offspring to the early development of nonalcoholic fatty liver disease (NAFLD) which is characterized by altered regulatory function beginning in utero and persisting throughout the life cycle.

Maternal dyslipidemia during pregnancy and lactation increases blood pressure and disrupts cardiorespiratory and glucose hemostasis in female rat offspring

Hypertension and metabolic disorders evidenced in adults who have been exposed to nutritional insults during early life may be sex-dependent. We evaluated if blood pressure (BP), cardiorespiratory control, and metabolic parameters are affected in female offspring (FO) from dams fed a dyslipidaemic diet during pregnancy and lactation. FO was obtained from dams who received control (CTL) or dyslipidaemic diets during pregnancy and lactation. The effects of a maternal dyslipidaemic diet on BP, cardiorespiratory control, and biochemical parameters were assessed at 30 and 90 days of age. The experimental protocol based on a dyslipidaemic diet intervention was effective in developing maternal dyslipidemia. At 30 days of age, the FO from dyslipidaemic dams displayed disordered respiratory pattern, enhanced ventilatory response to hypercapnia (P < 0.05), and increased serum levels of total cholesterol and triglycerides (P < 0.05) when compared with CTL female offspring. At 90 days of age, FO from dyslipidaemic dams had augmented BP (P < 0.05), exacerbated cardiorespiratory responses to hypercapnia (P < 0.05), enhanced pressor responses to peripheral chemoreflex activation (P < 0.05), impaired baroreflex (P < 0.05), and larger delta variations in arterial pressure after ganglionic blockade (P < 0.05). Furthermore, during oral glucose and insulin tolerance tests, FO from dyslipidaemic dams exhibited altered glucose tolerance and insulin sensitivity (P < 0.05) when compared with FO from CTL dams. Altered breathing linked to enhanced central and peripheral chemosensitivity, impaired baroreflex, and augmented sympathetic tone may be predisposing factors for increased BP and metabolic disorders in female offspring from dyslipidaemic dams.

Maternal dyslipidemia during early pregnancy and epigenetic ageing of the placenta

Disruption of physiological ageing of the placenta is associated with obstetric complications. Altered lipid metabolism is a known trigger of tissue ageing, but the effect of maternal dyslipidemia on placental ageing is not clearly understood. We examined the relationship between maternal dyslipidemia and placental age acceleration (PAA), an epigenetic ageing measure derived from the difference between DNA methylation age and chronological gestational age. We also assessed whether the association varies by maternal pre-pregnancy obesity status and fetal sex. Placental data were obtained as part of the NICHD Fetal Growth Studies that involved participants from four race/ethnic groups. Placental DNA methylation age was estimated using 62 CpGs that have previously been found to have high placental age prediction accuracy. We used multivariable linear regression to test associations between maternal dyslipidemia during early gestation (i.e., high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), total cholesterol (TChol), and triglycerides) and PAA adjusting for fetal sex and socio-demographic factors. Among normal-weight women, low HDLc, compared to high HDLc, was associated with 0.82 (95% CI: 0.00, 1.64) weeks higher PAA. Among women with female neonates, low HDLc, compared to high HDLc, was associated with 1.20 (95% CI: 0.17, 2.24) weeks higher PAA. High TChol was associated with 1.28 (95% CI: 0.12, 2.45) weeks higher PAA among Whites. In all, the study found that maternal dyslipidemia due to low HDLc was associated with accelerated epigenetic ageing of the placenta among mothers with normal pre-pregnancy weight and a female fetus.