Correlation Between Blood Lipid, Uric Acid Metabolism And Progression Of Hypertensive Disorder Complicating Pregnancy

Objective:To explore the influence of blood lipid and uric acid metabolism indicators on hypertensive disorder complicating pregnancy in different progressed stages,and to analyze the differences in blood lipids and uric acid metabolism inhypertensive disorder complicating pregnancy patients with different childbearing times so as to provide clinical evidence for early prevention and intervention ofpregnancy-induced hypertension.Methods:A total of 205 hospitalized patients with hypertensive disorder complicating pregnancy for childbirth in Yidu Central Hospital in Weifang from June2015 to 2017 were selected as research objects,and were further divided into 3subgroups,including gestational hypertension group(n=63,first child delivery in 19patients,and second child delivery in 44),mild preeclampsia(n=62,first child delivery in23 patients,and second child delivery in 39),and severe preeclampsia(n=80,first child delivery in 30 patients,and second child delivery in 50).Meanwhile,another 131 normal pregnant women including 60 patients with first child delivery,and 71 with second child delivery in the same period were included as controls.Clinical data in maternal age,delivery times,height,body mass,pregnancy termination of gestational week,blood pressure(BP),blood lipids indicators(TC,TG,HDL-C,LDL-C),and uric acid were collected.Univariate and multivariate logistic regression analysis were performed to analyze the risk factors of occurrence and progression of hypertensive disorder complicating pregnancy.Results:1.There was no significant difference in age of the pregnancy with one child delivery in four groups(p=0.183>0.05),but other indictors showed significant differences(p<0.05).The levels of UA,TC,TG were(421.93±80.5)umol/L,(7.21±1.98)mmol/L,(4.53±1.6)mmol/L,respectively,in the severe preeclampsia group,(326.91±68.29)umol/L,(5.65±1.42)mmol/L,(3.34±1.56)mmol/L,respectively,in mild preeclampsia group,(319.37±90.4)umol/L,(5.48±0.96)mmol/L,(2.73±1.19)mmol/L,respectively,in the gestational hypertension group,and were(255.85±70.49)umol/L,(4.59±0.92)mmol/L,(2.28±1.13)mmol/L,respectively,in the normal pregnancy group,and rank of above indicators in the four groups in reducing sequence were as follows:severe preeclampsia group,mild preeclampsia group,gestational hypertension group,normal pregnancy group.Severe preeclampsia group had higher HDL-C levels than normal pregnancy group(1.72±0.45 vs.1.49±0.33 mmol/L,p<0.05).LDL-C levels in severe preeclampsia group,mild preeclampsia group,gestational hypertension group and normal pregnancy group were(3.54±1.33),(2.46±0.79),(2.56±0.66),(1.98±0.57)mmol/L,respectively,which revealed that the severe preeclampsia group was higher than the other three groups(p<0.05).The body mass index(BMI)in the normal pregnancy group were(27.84±3.84)kg/m~2,which were lower than(31.16±4.48)kg/m~2in the gestational hypertension group,(31.08±4.75)kg/m~2 in the mild preeclampsia group,and(32.68±5.06)kg/m~2in the severe preeclampsia group.2.No significant difference was seen in age and HDL-C of the pregnancy with second child delivery in four groups(P>0.05).The levels of UA,TC,TG were(396.24±87.66)umol/L,(6.61±1.66)mmol/L,(4.1±1.91)mmol/L,respectively,in the severe preeclampsia group,(309.95±99.33)umol/L,(5.52±1.28)mmol/L,(3.1±1.29)mmol/L,respectively,in mild preeclampsia group,(309.8±91.53)umol/L,(5.38±0.98)mmol/L,(2.98±1.46)mmol/L,respectively,in the gestational hypertension group,and were(252.42±53.33)umol/L,(4.75±0.66)mmol/L,(2.52±0.89)mmol/L,respectively,in the normal pregnancy group.Therefore,the severe preeclampsia group had the highest levels of above indicators,followed by mild preeclampsia group,and gestational hypertension group,and the normal pregnancy group ranked the last.Meanwhile,the level of LDL-C in the severe preeclampsia group was(3.31±1.17)mmol/L,which was significantly lower than(2.47±0.75)mmol/L in the mild preeclampsia group,(2.49±0.72)mmol/L in the gestational hypertension group and(1.9±0.44)mmol/L in the normal pregnancy group.The normal pregnancy group had lower BMI than gestational hypertension group,mild preeclampsia group and normal pregnancy group(27.94±4.83vs.32.73±5.23,31.34±5.15,30.69±4.48 kg/m~2,respectively).3.Multivariate analysis by binary logistic regression analysis showed that BMI,UA,and level of LDL-C showed significant differences between gestational hypertensive patients and normal pregnant patients(P<0.05,RR:1.208,1.012,3.368;95%CI:1.122-1.300,1.007-1.017,1.402-8.086).Conclusions:BMI,and LDL-C are risk factors of gestational hypertension,and the levels of TC,TG are increased by the severity of gestational hypertension.Meanwhile,UA is also one of the risk factors for the occurrence of gestational hypertension,and is elevated by the severity of gestational hypertension,which can be a indicator for prediction of disease development.The results showed that age composition of patients with first or second child delivery in our hospital is changed.Multivariate analysis shows that there is no positive correlation between delivery times and gestational hypertension,but the patients with first or second child delivery share the same risk factors,and risk factors in BMI,LDL-C,UA are elevated.