Comparison of global definitions of metabolic syndrome in early pregnancy among the Rajarata Pregnancy Cohort participants in Sri Lanka

Imasha Upulini Jayasinghe,Shalka Madushan Srimantha,Thilini Chanchala Agampodi,Ajith Kumara Dissanayake,Suneth Buddhika Agampodi

doi:10.1038/s41598-022-05919-z

Imasha Upulini Jayasinghe, Shalka Madushan Srimantha + Show 3 more

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https://doi.org/10.1038/s41598-022-05919-z

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Journal: Scientific Reports	Publication Date: Feb 7, 2022
Citations: 2	License type: open-access

Affiliation: Rajarata University of Sri Lanka

Abstract

Metabolic syndrome (MetS) in pregnancy shows epigenetic associations with intergenerational inheritance of metabolic diseases. The presence of different diagnostic criteria influences MetS prevalence estimates. We evaluated MetS and metabolic derangements to determine the utility of its assessment in early pregnancy. A cross-sectional analysis of metabolic derangements in pregnant women with period of gestation (POG) ≤ 12 weeks was done among Rajarata Pregnancy Cohort participants in Sri Lanka. 2682 women with mean age 27.9 year (SD-5.5) and median POG 8.0wk (IQR-3) were analyzed. Mean levels of triglycerides (TG), total cholesterol (TC), high-density-lipoprotein (HDL), low-density-lipoprotein (LDL), fasting plasma glucose, and 2 h oral glucose tolerance test were 87.71 (SD 38.7), 172.2 (SD 34.7), 49.6 (SD 11.5), 122.6 (SD 32.3), 82.2 (SD 12.8) and 120.3 (SD 11.5) respectively. All serum lipids except LDL increase significantly from 6 to 12 weeks, with TG by 23 and TC by 8 units. High MetS prevalence was observed with AHA/NHLBI (n = 150, 5.6%, 95% CI 4.8–6.5) followed by IDF (n = 144, 5.4%, 95% CI 4.6–6.3), NCEP-ATP III (n = 112, 4.2%, 95% CI 3.4–5.0) and WHO (n = 81, 3.0%, 95% CI 2.4–3.7) definitions respectively. Significant difference in prevalence was noted among different sociodemographic characteristics (p < 0.001). Regardless of the criterion used, the change of metabolic parameters in early pregnancy leads to significant differences in prevalence estimates of MetS. The best MetS definition concerning pregnancy outcomes needs to be determined with prospective studies.

Highlights

Metabolic syndrome (MetS)[1], is a cluster of metabolic derangements linked with central obesity, which are known to increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD)[2,3,4]
Using a large population based maternal cohort, we found a 5.4% (CI 4.6–6.3) prevalence of MetS among pregnant women in rural Sri Lanka
The novelty and importance of this study is represented by capturing a district representative sample of pregnant women in very early in their pregnancy and use of standard rigorous techniques in obtaining the measurements

Summary

Introduction

Metabolic syndrome (MetS)[1], is a cluster of metabolic derangements linked with central obesity, which are known to increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD)[2,3,4]. In 1986, David Barker explained that exposure to the adverse intrauterine environment (restricted intrauterine resources) gives rise to metabolic disease in adulthood[14,15] This implicates developmental plasticity and fetal programming where maternal malnutrition affects fetal organogenesis in early fetal development[16]. The dynamic process of DNA methylation is epigenetically affected by maternal obesity and other associated metabolic derangements of MetS in its intrauterine e nvironment[19,20,21]. When a woman with high BMI enters pregnancy, she already has imbalanced adiponectin and leptin levels in the early prenatal period and it directly affects fetal metabolic programming resulting in increased birth weight and future growth trajectories towards obesity in the offspring[15,27,28].

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