The complex evaluation of lipid metabolism and blood coagulation system indicators for prediction and early diagnosis of the preeclampsia
DOI:
https://doi.org/10.15587/2519-4798.2016.87849Keywords:
preeclampsia, prognostication, lipids, triglycerides, D-dimer, soluble fibrin, fibrinogen, thrombosis, protein CAbstract
Aim. To study informative and prognostic significance of lipid metabolism markers and coagulation system condition for PE early diagnostics in pregnant women during the second gestational trimester with risk evaluation of cardiovascular and metabolic pathologies in the given women category.
Materials and methods. The analysis of blood serum samples in 267 pregnant women in II gestational trimester was carried out. The total cholesterol was determined by colorimetric method, enzymatic with CHOD/PAP, TG – by enzymatic colorimetric method, HDL – by homogeneous method, LDL – by direct method. VLDL concentration was calculated according to Fridvald's formula: VLDL = TG/2.2. AF was calculated according to the formula: AF = (TC-HDL-c)/HDL-c. Pregnant women in II and III gestational trimesters also were examined concerning the general assessment of coagulation system condition – the concentration in blood plasma of D-dimer, soluble fibrin (SFMC), fibrinogen, FIPF, protein C activity, AT III, blood plasma clotting time was determined by PT test.
Results. Of the 267 pregnant women, in 43 (16.1 %) of them, which formed the main group for research, the development of PE was found. Those pregnant women, who had PE clinical picture of the different severity levels, from the second trimester had significantly elevated TG, VLDL, AF levels, and low level of HDL in blood serum with high concentration of D-dimer (from 80 to 713 ng/ml), as well as protein C low activity in 17.6 % of pregnant women. In the third trimester pregnant women, having PE, fibrinogen content was significantly higher (4.4±1.02); the accumulation of a significant amount of SF, accompanied by FIPF presence in 40 % of pregnant women, was found in 50 % of pregnant women; a significant reducing (˂70 %) of the protein C activity was found in 48 % of patients.
Conclusion. Both significant increasing of the soluble fibrin in blood plasma, and reducing of the protein C activity below 70 % are thrombosis prognostic indexes. The control of lipid metabolism and coagulation system indexes is necessary during all stages of pregnancy for estimation of PE risk and cardiovascular,cerebral vascular and metabolic complications preventionReferences
- Gongora, M., Wenger, N. (2015). Cardiovascular Complications of Pregnancy. International Journal of Molecular Sciences, 16 (10), 23905–23928. doi: 10.3390/ijms161023905
- Savitz, D. A., Danilack, V. A., Elston, B., Lipkind, H. S. (2014). Pregnancy-Induced Hypertension and Diabetes and the Risk of Cardiovascular Disease, Stroke, and Diabetes Hospitalization in the Year Following Delivery. American Journal of Epidemiology, 180 (1), 41–44. doi: 10.1093/aje/kwu118
- Zaporozhan, V. N., Tyutrin, I. I., Udut, V. V. et. al. (2014). State of regulatory system of blood aggregation in pregnant woman with preeclampsia according to the low frequency pyezothromboelastography “Global test”. Clinical Anesthesiology & Intensive Care, 1 (3), 5–14.
- Klimencova, V. D. (2015). Narusheniya sistemu regulyacii agregatnogo sostoyaniya krovi pri preeclampsia i monitoring ih medikamentoznoy korekcii [Disturbances of regulatory system of blood aggregation in case of preeclampsia and its drug correction]. Tomsk, 23.
- Tyutrin, I. I., Udut, V. V., Shpisman, M. N. (2013). Nizkochastotnaya pyezotroboelastografiya v diagnostike gemostaziologicheskikh rasstroystv [Low-frequency piezoelectric thromboelastography in diagnosing hemostatic disorders (Guidelines)]. Tomsk, 67.
- Uzan, J., Carbonnel, M., Piconne, О., Asmar, R., Ayoubi, J.-M. (2011). Preeclampsia: pathophysiology, diagnosis and management. Vascular Health and Risk Management, 467–474. doi: 10.2147/vhrm.s20181
- Bulanov, A. Y. (2011). Hemostasis in acute blood loss. Tolyatinskiy medicinskiy consilium, 3-4, 26–28.
- Sidorova, I. S., Zarubenko, N. B., Gurina, O. I. (2010). Endothelium dysfunction markers in. Russian messenger of obstetrician-gynaecologist, 5, 24–27.
- Fanshawe, A. E., Ibrahim, M. (2013). The current status of lipoprotein (a) in pregnancy: A literature review. Journal of Cardiology, 61 (2), 99–106. doi: 10.1016/j.jjcc.2012.09.009
- Mukherjee, M. (2014). Dyslipidemia in Pregnancy (Expert analysis). American College of cardiology. Available at: http://www.acc.org/latest-in-cardiology/articles/2014/07/18/16/08/dyslipidemia-in-pregnancy
- Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H. et. al. (2013). 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Circulation, 129 (25), S1–S45. doi: 10.1161/01.cir.0000437738.63853.7a
- Goldberg, A. S., Hegele, R. A. (2012). Severe Hypertriglyceridemia in Pregnancy. The Journal of Clinical Endocrinology & Metabolism, 97 (8), 2589–2596. doi: 10.1210/jc.2012-1250
- Aryal, M., Poudel, A., Satyal, B., Gyawali, P., Pokharel, B. R., Raut, B. K. et. al. (2010). Evaluation of non-HDL-c and total cholesterol: HDL-c ratio as cumulative marker of cardiovascular risk in diabetes mellitus. Kathmandu Univ Med J (KUMJ), 8 (32), 398–404.
- Platonova, T. N., Zaichko, N. V., Chernushenko, T. M., Gornickaya, O. V., Grishuk, V. I. (2010). Evaluation of informativeness and prognostic significance of traditional scrining additional laboratory tests for the diagnosis of thrombophilia. Laboratory diagnosis, 4 (54), 3–10.
- Sokolovskaya, A. S., Platonova, T. N., Grinenko, T. V., Chernushenko T. M., Ivanenko, T. I. (2006). Comparative characteristics of methods for determination of fibrinogen in the blood plasma. Observed. and Clinic. Physiol. and biochemistry, 3, 82–86.
- Dolgov, V. V., Svirin, P. V. (2005). Laboratory dіagnosis of the hemostasis disorders. Tver, 227.
- Gornickaya, O. V., Platonova, T. N. (2003). Isolation and properties of protein C activator from the venom of the ordinary copperhead snake. Biomed. Chemistry, 49 (5), 470–478.
- Rebrova, O. Y.(2010). Statistical analysis of medical data. Using of the application package STATISTICA. Moscow: Media Sfera, 305.
- Savchuk, O. M., Gamisonia, M. Sh., Platonova, T. N., Makagonenko, E. M. (2000). Early diagnosis and prevention of thrombotic complications after surgery cesarean section. Pediatrics, Obstetrics and Gynecology, 3, 104–107.
- Ismail, S. K., Higgins, J. (2011). Hemostasis in Pre-Eclampsia. Seminars in Thrombosis and Hemostasis, 37 (02), 111–117. doi: 10.1055/s-0030-1270336
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Ірина Борисівна Венцківська, Анастасія Валеріївна Аксьонова, Тетяна Миколаївна Платонова, Ірина Миколаївна Колесникова, Олена Олегівна Наложитова
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.