Abstract
BackgroundIn pregnancy lipid levels increase with gestation resembling an atherogenic lipid profile. Currently it is unclear whether gestational lipid levels are associated with an adverse cardiovascular risk profile later in life. The aim of this study is to assess the association between gestational lipid levels and lipid levels and prevalence of the metabolic syndrome (MS) six years after pregnancy.MethodsIn plasma of 3510 women from the Generation R Study; a prospective population-based cohort, we measured lipid levels (total cholesterol, triglycerides and high-density lipoprotein cholesterol [HDL-c]), and low-density lipoprotein cholesterol (LDL-c), remnant cholesterol and non-HDL-c were calculated in early pregnancy (median 13.2 weeks, 90% range [10.5 to 17.1]) and six years after pregnancy (median 6.5 years, 90% range [6.2 to 7.8]). MS was assessed six years after pregnancy according to the NCEP/ATP3 criteria. We also examined the influence of pregnancy complications on these associations.ResultsGestational lipid levels were positively associated with corresponding lipid levels six years after pregnancy, independent of pregnancy complications. Six years after pregnancy the prevalence of MS was 10.0%; the prevalence was higher for women with a previous placental syndrome (13.5%). Gestational triglycerides and remnant cholesterol in the highest quartile and HDL-c in the lowest quartile were associated with the highest risk for future MS, independent of smoking and body mass index.ConclusionsGestational lipid levels provide an insight in the future cardiovascular risk profile of women in later life. Monitoring and lifestyle intervention could be indicated in women with an unfavorable gestational lipid profile to optimize timely cardiovascular risk prevention.
Highlights
In pregnancy lipid levels increase with gestation resembling an atherogenic lipid profile
Women who develop a hypertensive disorder of pregnancy such as gestational hypertension or pre-eclampsia have a 2–8 times higher risk of developing chronic hypertension, metabolic syndrome and cardiovascular disease (CVD) later in life compared to women with an uncomplicated pregnancy [3, 7,8,9,10,11]
We examined the distribution of lipid levels in early pregnancy for all women with and without the metabolic syndrome six years after pregnancy (Table 2)
Summary
In pregnancy lipid levels increase with gestation resembling an atherogenic lipid profile. It is unclear whether gestational lipid levels are associated with an adverse cardiovascular risk profile later in life. Pregnancy has been proposed as a natural ‘stress test’ to predict the risk of cardiovascular disease (CVD) later in life [1]. Women who develop a hypertensive disorder of pregnancy such as gestational hypertension or pre-eclampsia have a 2–8 times higher risk of developing chronic hypertension, metabolic syndrome and CVD later in life compared to women with an uncomplicated pregnancy [3, 7,8,9,10,11]. Less is known about the long term cardiovascular effect of gestational lipid levels. Lipid levels in general normalize to prepregnancy levels within three to four months [16,17,18]
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