123 The serum behavior of lipoproteins and inflammatory substrates in the mediate and late puerperium in preeclampsia

Abstract

Currently, two factors are considered important in the pathophysiology of preeclampsia: lipid peroxidation and exacerbated inflammatory response. The reduction in the clinical expression of preeclampsia 12 weeks postpartum motivates the search to recognize the behavior of lipoprotein and inflammatory substrates. Evaluate the influence of lipoprotein and inflammatory markers in women with preeclampsia during the mediate and late postpartum. Cohort study developed at the Guilherme Álvaro Hospital- Santos/Brazil. Were collected blood samples of 107 patients (48 case group and 59 control group) from January/2015 to May/2016 in the mediate postpartum. After that, the same women returned to the second sample, 12 weeks postpartum. It was a total of 31 patients (17 case group and 14 control group). Lipoprotein substrates and selected inflammatory possibly related to preeclampsia were analyzed. Group case: women with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: patients after vaginal delivery with term newborn without hypertension and/or other comorbidities. Exclusion criteria: collagen disease, smoking, twin pregnancy, previous diagnosis of diabetes mellitus and fetal malformations. Variables analyzed: total cholesterol, LDL (low-density lipoprotein) fraction, triglycerides, fasting glucose, insulin, HOMA-IR, C-reactive protein (CRP), total protein, albumin, globulin, uric acid, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), gamma-glutamyl transferase (GGT). For the descriptive measures of each variable of interest we calculate in the two evaluations. Then to study the behavior of the variables of interest in the chosen group, in the two assessments, we used the model of multivariate analysis and repeated measures. Comparison of possible lipoprotein and inflammatory markers results (∗p < 0.05) We considered p, as the variables that have changed uniformly between the groups comparing the mediate and the late puerperium. Download : Download high-res image (187KB)Download : Download full-size image The glycidic and inflammation effectors such as blood glucose, insulin, HOMA -IR, C-reactive protein and uric acid showed uniform and significant changes between the groups comparing mediate and late postpartum. Lipoproteins indicated an upward trend in women with preeclampsia, while total protein, albumin and globulin fractions seem to be reduced in this group. Comparing the mediate and late postpartum period we identified a significant difference between the serum levels of lipotoxicity and inflammatory markers.