摘要
Abstract
Objective To investigate the association between apolipoprotein A(ApoA)and glucose and lipid metabolism disorders and pregnancy outcomes in patients with preeclampsia(PE).Methods A total of 230 pregnant women with preeclampsia admitted to Hebei PetroChina Central Hospital from January 2023 to June 2024 were retrospectively selected,and they were divided into normal glucose and lipid metabolism group(n=123)and abnormal glucose and lipid metabolism group(n=107)according to glucose and lipid metabolism,and the general data of the two groups were collected.Multiple linear regression analysis was used to analyze the relationship between ApoA and glycolipid metabolism indexes.Logistic regression analysis analyzed the correlation between ApoA and glucose and lipid metabolism disorders.According to the pregnancy outcomes,patients were divided into good pregnancy outcome group(n=162)and adverse pregnancy outcome group(n=68),and the influencing factors of adverse pregnancy outcomes were analyzed by multivariate logistic regression.A mediating effect model was constructed to analyze the effect of glucose and lipid metabolism disorders on the relationship between ApoA and pregnancy outcomes in PE patients.Based on the limiting cubic spline model,the dose-response relationship between ApoA and adverse pregnancy outcomes was analyzed.Log-biological regression analysis was used to analyze the association of ApoA with adverse pregnancy outcomes and its subtypes in PE patients.Results With the increase of ApoA level,fasting plasma glucose(FPG),fasting insulin(FINS),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and glycosylated hemoglobin(HbA1c)increased(β＞0,P＜0.05),and low-density lipoprotein cholesterol(LDL-C)decreased(β＜0,P＜0.05).ApoA was closely related to glucose and lipid metabolism disorders(Ptrend＜0.05).ApoA,FPG,HDL-C,LDL-C and HbA1c were the influencing factors of adverse pregnancy outcomes(OR values were 2.875,3.821,3.335,3.289 and 1.793,P＜0.05),respectively,and glucose and lipid metabolism disorders had a significant mediating effect on pregnancy outcomes between ApoA and PE patients(β=0.638,P＜0.001).ApoA was significantly negatively associated with adverse pregnancy outcomes,especially when ApoA＜1.43mg/L,and the risk of adverse pregnancy outcomes increased significantly as ApoA decreased.The incidence of adverse pregnancy outcomes in pregnant women with PE was 29.57％,of which 88.24％were pregnant women with low ApoA level,which was significantly higher than that of pregnant women with high ApoA level(11.76％),and ApoA level was negatively correlated with the incidence of adverse pregnancy outcomes(RR＜1).Conclusion The decrease of ApoA level is closely related to the occurrence of glucose and lipid metabolism disorders in pregnant women with PE,which can easily increase the risk of adverse pregnancy.关键词
载脂蛋白A/子痫前期/糖脂代谢紊乱/妊娠结局Key words
apolipoprotein A/preeclampsia/glucose and lipid metabolism disorder/pregnancy outcome分类
医药卫生
