ATHEROGENIC PARAMETERS AND CARDIAC INDICES IN PROGNOSTICATION OF DEVELOPMENT OF PRE-ECLAMPSIA AND ITS CARDIOMETABOLIC CONSEQUENCES
Aim of the work. The study of interconnection between atherogenic parameters of the blood serum and cardiac indices during pregnancy with the risk of pre-eclampsia development and prognostication of remote cardio-vascular and/or metabolic pathology among pregnant.
Materials and methods. The indices of lipid metabolism in the blood serum of 267 pregnant women were studied using diagnostic sets of reagents. The blood sampling was carried out in II (16-24 gestational weeks) trimester. The general cholesterol (GC) and triglycerides (TG) were determined by colorimetric and enzymatic method; high-density lipoproteins – HDL – by homogenous method of direct determination of HDL-cholesterol concentration in the blood serum without preliminary processing and centrifugation, low-density lipoproteins – LDL – by the direct method. VLDL concentration was calculated by Friedewald formula: LDL = TG/2,2.
For evaluation of GC-VLDL concentration TG/2,2 parameter is used, if TG concentration is expressed in mmol/l (or TG/5, if concentration is expressed in mg/100 ml).
Cardiac indices were calculated taking into account the lipid parameters according to the correspondent mathematical formulas. Lactate and LDH concentrations were determined by optimized method using diagnostic reagents. Lactate concentration was determined at the use of diagnostic set for determination of lactate concentration, and DLH was also determined by diagnostic set for determination of LDH (DL) activity by optimized method, elaborated taking into account the recommendations of German Association of clinical chemistry (DGKC) after correspondent calibration of automatic analyzer ACCENT-200 II GEN. Depending on the development of clinical presentation of PE 43 women were divided in groups with light and middle severity of course of this pathology.
Results and discussion. Among the women with PE development was observed the essential changes in II trimester in the aspect of atherogenic parameters and cardiac indices mainly at the expense of progressing increase of TG in the blood serum (mmol/l: I group - 1,73 ± 0,14, II group - 1,86 ± 0,18 comparing with III control group - 1,51 ± 0,06. The gradual growth of cardiac (atherogenic) indices - AIP, CR and CА and connection between AIP and the levels of maternal serumal TG and arterial pressure were observed in women with PE development at the absence of such connection among the women of control group (p <0,05) . LDH level grew with the progressing of PE severity: for the women of I group LDH level was - 389 ± 1,6 U/l at 778 ± 0,25 in women of II group and 265 ± 0,19 in the control group (p <0,05).
Conclusions. It was demonstrated, that hypertriglyceridemia at pregnancy is a predicator relative to PE development and together with progressive growth of atherogenic indices can be considered as prognostic factor for cardiometabolic pathology, especially in women with undergone severe forms of this pathology. It was established, that the increase of LDH level since the second trimester can also testify to the development of PE and remote cardiac pathology in this category of women.
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