Lipid status in phyisiological non-complicated pregnancy

Abstract

Specifically altered lipid profile and physiological hyperlipidemia during pregnancy are considered essential for the normal course of pregnancy and fetal development. This specific alteration of the lipid profile raises the questions about potential proaterogenic effect of these altered lipid parameters during pregnancy and its influence on the development of cardiovascular disease in women later in life. Research topic was also the association of altered lipid profile during pregnancy with the development of complications in pregnancy, especially gestational diabetes, hypertension and preeclampsia. Through the mediation of cholesterol ester transfer protein (CETP), the activity of which grows in mid-gestation, there are exchanges of the triglycerides between VLDL and LDL or HDL particle, which leads to increased accumulation of triglycerides in these particles, causes them to become smaller and denser with much greater atherogenic potential. These changes in lipid profile point out that a large number of pregnancies increase risk of development of cardiovascular diseases later in life. In order to optimize the predictive capacity of the lipid profile during pregnancy, it is recommended to determine the indexes of lipid.

Specifično izmenjen lipidni profil i fiziološka hiperlipidemija tokom trudnoće smatraju se esencijalnim za normalan ishod trudnoće i razvoj fetusa, a upravo ova specifičnost promena parametara lipidnog profila otvara pitanja njihove potencijalne proaterogenosti tokom trudnoće i uticaja na rizik za razvoj kardiovaskularne bolesti u kasnijem životu žene. Takođe se ispituje i povezanost izmenjenog lipidnog profila tokom trudnoće sa razvojem komplikacija u trudnoći, pre svega sa razvojem gestacijskog dijabetesa, hipertenzije i preeklampsije. Posredovanjem holesterol estar transportnog proteina (CETP), čija aktivnost raste sredinom trudnoće, dolazi do izmene triglicerida i holesterola između lipoproteinskih čestica vrlo niske gustine (VLDL) i lipoproteinskih čestica male gustine (LDL) ili lipoproteinskih čestica velike gustine (HDL), tako da dolazi do povećanog nakupljanja triglicerida u LDL i HDL česticama, pri čemu one postaju manje i gušće, i kao takve imaju veći proaterogeni potencijal, što sve ukazuje i na proaterogeni potencijal trudnoće, posebno ukoliko se ona ponavlja više puta tokom života. Da bi se optimizirao prediktivni kapacitet lipidnog profila tokom trudnoće preporučuje se određivanje lipidnih indeksa.