The impact of preconceptional overweight on dynamics of maternal carbohydrate and lipid metabolisms during pregnancy
DOI:
https://doi.org/10.32782/2415-8127.2022.65.10Keywords:
pregnancy, overweight, carbohydrate-lipid metabolisms, insulin resistance, gestational weight gain.Abstract
Introduction. During pregnancy physical and metabolic changes in maternal organism occur for fetal development, which associate with pre-pregnancy weight and gestational weight gain (GWG). Aim: to study the dynamics of carbohydrate and lipid metabolisms in preconceptional overweight pregnant depending on the level of GWG. Materials and methods. 68 overweight and 49 normal weight pregnant women were examined. Body mass index (kg/m2) was calculated, GWG level, percentage of body fat based on spectral bioimpedancometry, serum fasting and postprandial glucose levels, insulin, and insulin resistance index (HOMO-IR), triglycerides (T), general cholesterol (GC), high, low and very low density lipoproteins (HDL, LDL, VLDL) were performed in the first and third trimesters of pregnancy. The results were statistically analyzed using a statistical analysis package based on Microsoft Excel and Statistica 12.0 program pack (StatSoft Inc., USA). The differences between the selections were considered statistically reliable at p<0.05. Research results. Overweight pregnant women in the first trimester had higher concentrations of fasting glucose, insulin, HOMO-IR, Ts, LDL and VLDL compared to normal weight pregnant (p<0.05). In recommended GWG in the group of overweight patients the state of compensatory hyperinsulinemia with the normal glucose level, increased T, GC, LDL, VLDL levels at the end of pregnancy were found, but at a much lower percent than in the group of normal weight women. In excessive GWG, the state of hyperglycemia with high HOMO-IR, a significant increase in hypertriglyceridemia and hyper/dyslipidemia in the third trimester indicated the beginning of the development of metabolic decompensation. Conclusions. Excessive GWG is associated with the development of pathological insulin resistance, hypertriglyceridemia and hyper/dyslipidemia on the background of existing pre-pregnancy insulin resistance, which may be consider the pathogenetic basis of energy dysfunction and reduced of mother adaptability to pregnancy.
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