Abstract
Objective: This study aims to investigate the efficiency of insulin on the reduction of gestational lipid profiles and try to propose a real-world approach to assist clinicians. Methods: A retrospective, single-centered cohort study of 35 cases was conducted from October 2018 to July 2021 in Shanghai General Hospital. SPSS version 25.0 was performed to analyze the whole data. For continuous variables, a paired-sample t test was carried out on each variable to make a comparison between before and after treatment. Results: The average pre-pregnancy TGs and TCs of these patients were about 3.96 ± 1.42 mmol/L and 4.78 ± 1.18 mmol/L, respectively. The maximum of TG before insulin treatment was up to 64.62 and TC 20.43 mmol/L, which decreased to 17.34 and 4.92 mmol/L after intervention of the insulin drip. TG was noticed to fall by 77% and 12.71% of TG, respectively. The difference of TG and TC between pre-treatment and post-treatment were statistically significant (p < 0.01), while this difference has not been found in the other laboratory tests reports. The outcomes of newborns and mothers with management of insulin were proven to be improved. Conclusion: The use of insulin in the management of gestational hypertriglyceridemia is safe and efficient, and insulin may become a mainstream in the near future to mitigate serum TG and TC levels in the pregnancy period besides regulating the blood glucose level.
Highlights
During normal pregnancy, the concentration of all lipoprotein increases physiologically, which seem to be originally hormonally mediated, and most of the healthy pregnant women can tolerate such changes and will not cause obvious adverse outcomes
1) Age in years, kg, cm, kg/m2, g, and days are the units of age, weight, height, BMI, review intervals, and mmol/for total cholesterol (TC), TG, low density lipoprotein (LDL), high-density lipoprotein (HDL), and baby weight, while g/l is for apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB)
There were 48.57% of all the enrolled cases who were diagnosed with GDM, which was not surprising as diabetes can play a role in the development of HTG
Summary
The concentration of all lipoprotein increases physiologically, which seem to be originally hormonally mediated, and most of the healthy pregnant women can tolerate such changes and will not cause obvious adverse outcomes. Treatment of Hypertriglyceridemia During Pregnancy With Insulin for clinicians to deal with such cases as currently absence of safety data of this period for most lowering-serum lipid medicine. Being in such a particular period—pregnancy period—with no safe access to other treatment options, patients in our institution were given insulin drip as the related literature demonstrated. Dietary restriction of high-fat food such as cakes and biscuits has long been the cornerstone of therapy since lipidlowering agents in pregnancy have been only scarcely studied in pregnant women, and there is limited information regarding fetal effects (Rouhi-Boroujeni et al, 2017),but this measure is usually not sufficient and strong enough to control the severity of HTG. Admission to hospital for intensive dietary control is imperative, provided that the patient is not be able to conduct strict low-fat dietary, and being fasting in conjunction with total parenteral nutrition (TPN) is advised if necessary
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