{"title":"中国东南地区孕妇血脂水平的孕期特异性参考区间及其与不良妊娠结局的关系","authors":"Lili Yang, Zhaozhen Liu, Jiayi Chen, Chong Miao, Qingxiu Li, Jinying Chen, Wenjuan Liu, Haiyan Gao, Wei Li, Zhengqin Wu, Bin Sun, Yibing Zhu, Haibo Li","doi":"10.1186/s12944-025-02494-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Trimester-specific reference intervals (TSRIs) for maternal lipid profiles should be determined, and the impact of dyslipidemia on adverse pregnancy outcomes (APOs) should be estimated.</p><p><strong>Methods: </strong>Data from 25,081 pregnant women in a large Southeast Chinese cohort were collected. Serial lipid profiling was performed throughout gestation, with measurements obtained during the first, second, and third trimesters, as well as within 24 h of delivery. The truncated maximum likelihood (TML) method, the Hoffman method, and inverse modelling were employed to establish TSRIs for lipids, with TML as the primary method. The associations of dyslipidemia with APOs were investigated by logistic regressions within the setting of TSRIs for various lipids.</p><p><strong>Results: </strong>The TSRIs established by the TML method were as follows: 3.36-6.06, 4.19-7.89, 4.60-8.97, and 4.41-8.79 mmol/L for total cholesterol; 0.66-2.32, 1.11-3.75, 1.49-4.77, and 1.61-6.14 mmol/L for triglycerides; 1.42-3.61, 1.94-5.13, 1.95-5.39, and 1.86-5.50 mmol/L for low-density lipoprotein cholesterol; 1.11-2.31, 1.30-2.75, 1.24-2.59, and 1.20-2.65 mmol/L for high-density lipoprotein cholesterol; 1.89-4.20, 2.59-5.85, 2.87-6.17, and 2.88-6.78 mmol/L for non-high-density lipoprotein cholesterol; 1.04-1.96, 1.25-2.41, 1.23-2.46, and 1.25-2.47 g/L for apolipoprotein A1; 0.43-0.82, 0.63-1.17, 0.65-1.55, and 0.79-1.77 g/L for apolipoprotein B; and 0.27-0.79, 0.35-0.94, 0.39-1.11, and 0.40-1.15 for the apolipoprotein B and apolipoprotein A1 ratio from the first trimester to the delivery period, respectively. The results of the Hoffman and inverse modelling methods closely aligned with those of the TML method. In pregnant women, lipid levels that deviate above or below the established TSRIs are significantly associated with the occurrence of APOs.</p><p><strong>Conclusion: </strong>TSRIs are recommended for the identification and management of dyslipidemia during pregnancy. Inappropriate maternal blood lipid levels are associated with an increased risk of APOs.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":"24 1","pages":"68"},"PeriodicalIF":3.9000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846285/pdf/","citationCount":"0","resultStr":"{\"title\":\"Trimester-specific reference intervals for blood lipid levels and their associations with adverse pregnancy outcomes in Southeast China.\",\"authors\":\"Lili Yang, Zhaozhen Liu, Jiayi Chen, Chong Miao, Qingxiu Li, Jinying Chen, Wenjuan Liu, Haiyan Gao, Wei Li, Zhengqin Wu, Bin Sun, Yibing Zhu, Haibo Li\",\"doi\":\"10.1186/s12944-025-02494-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Trimester-specific reference intervals (TSRIs) for maternal lipid profiles should be determined, and the impact of dyslipidemia on adverse pregnancy outcomes (APOs) should be estimated.</p><p><strong>Methods: </strong>Data from 25,081 pregnant women in a large Southeast Chinese cohort were collected. Serial lipid profiling was performed throughout gestation, with measurements obtained during the first, second, and third trimesters, as well as within 24 h of delivery. The truncated maximum likelihood (TML) method, the Hoffman method, and inverse modelling were employed to establish TSRIs for lipids, with TML as the primary method. The associations of dyslipidemia with APOs were investigated by logistic regressions within the setting of TSRIs for various lipids.</p><p><strong>Results: </strong>The TSRIs established by the TML method were as follows: 3.36-6.06, 4.19-7.89, 4.60-8.97, and 4.41-8.79 mmol/L for total cholesterol; 0.66-2.32, 1.11-3.75, 1.49-4.77, and 1.61-6.14 mmol/L for triglycerides; 1.42-3.61, 1.94-5.13, 1.95-5.39, and 1.86-5.50 mmol/L for low-density lipoprotein cholesterol; 1.11-2.31, 1.30-2.75, 1.24-2.59, and 1.20-2.65 mmol/L for high-density lipoprotein cholesterol; 1.89-4.20, 2.59-5.85, 2.87-6.17, and 2.88-6.78 mmol/L for non-high-density lipoprotein cholesterol; 1.04-1.96, 1.25-2.41, 1.23-2.46, and 1.25-2.47 g/L for apolipoprotein A1; 0.43-0.82, 0.63-1.17, 0.65-1.55, and 0.79-1.77 g/L for apolipoprotein B; and 0.27-0.79, 0.35-0.94, 0.39-1.11, and 0.40-1.15 for the apolipoprotein B and apolipoprotein A1 ratio from the first trimester to the delivery period, respectively. The results of the Hoffman and inverse modelling methods closely aligned with those of the TML method. In pregnant women, lipid levels that deviate above or below the established TSRIs are significantly associated with the occurrence of APOs.</p><p><strong>Conclusion: </strong>TSRIs are recommended for the identification and management of dyslipidemia during pregnancy. Inappropriate maternal blood lipid levels are associated with an increased risk of APOs.</p>\",\"PeriodicalId\":18073,\"journal\":{\"name\":\"Lipids in Health and Disease\",\"volume\":\"24 1\",\"pages\":\"68\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-02-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846285/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lipids in Health and Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12944-025-02494-w\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lipids in Health and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12944-025-02494-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
Trimester-specific reference intervals for blood lipid levels and their associations with adverse pregnancy outcomes in Southeast China.
Background: Trimester-specific reference intervals (TSRIs) for maternal lipid profiles should be determined, and the impact of dyslipidemia on adverse pregnancy outcomes (APOs) should be estimated.
Methods: Data from 25,081 pregnant women in a large Southeast Chinese cohort were collected. Serial lipid profiling was performed throughout gestation, with measurements obtained during the first, second, and third trimesters, as well as within 24 h of delivery. The truncated maximum likelihood (TML) method, the Hoffman method, and inverse modelling were employed to establish TSRIs for lipids, with TML as the primary method. The associations of dyslipidemia with APOs were investigated by logistic regressions within the setting of TSRIs for various lipids.
Results: The TSRIs established by the TML method were as follows: 3.36-6.06, 4.19-7.89, 4.60-8.97, and 4.41-8.79 mmol/L for total cholesterol; 0.66-2.32, 1.11-3.75, 1.49-4.77, and 1.61-6.14 mmol/L for triglycerides; 1.42-3.61, 1.94-5.13, 1.95-5.39, and 1.86-5.50 mmol/L for low-density lipoprotein cholesterol; 1.11-2.31, 1.30-2.75, 1.24-2.59, and 1.20-2.65 mmol/L for high-density lipoprotein cholesterol; 1.89-4.20, 2.59-5.85, 2.87-6.17, and 2.88-6.78 mmol/L for non-high-density lipoprotein cholesterol; 1.04-1.96, 1.25-2.41, 1.23-2.46, and 1.25-2.47 g/L for apolipoprotein A1; 0.43-0.82, 0.63-1.17, 0.65-1.55, and 0.79-1.77 g/L for apolipoprotein B; and 0.27-0.79, 0.35-0.94, 0.39-1.11, and 0.40-1.15 for the apolipoprotein B and apolipoprotein A1 ratio from the first trimester to the delivery period, respectively. The results of the Hoffman and inverse modelling methods closely aligned with those of the TML method. In pregnant women, lipid levels that deviate above or below the established TSRIs are significantly associated with the occurrence of APOs.
Conclusion: TSRIs are recommended for the identification and management of dyslipidemia during pregnancy. Inappropriate maternal blood lipid levels are associated with an increased risk of APOs.
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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