Reference intervals of serum lipids in the second and third trimesters of pregnancy in a Caucasian cohort: the LIFE Child study
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The study aimed to establish reference intervals for serum lipids and apolipoproteins in pregnant women depending on trimester and parity, and to investigate the influence of various factors on lipid and apolipoprotein concentrations.
Materials and methods
A total of 748 pregnant women (n = 683 in the second trimester, n = 676 in the third trimester) were included in the study and reference intervals for total cholesterol (TC), HDL, LDL, triglycerides (TG), apoA1 and apoB were determined as empirical quantiles. The measurement of serum lipids was performed using a validated specific homozygous enzymatic color test. Hierarchical models were used to investigate hypothesized relations.
Except for apoA1, all serum lipids levels showed a significant change from the second to the third trimester. This increase was most pronounced for TGs. Especially in the third trimester, the concentrations of serum lipids exceeded the currently accepted reference values for non-pregnant women by a factor of 2.5. Reference intervals of serum lipids at the second and third trimesters in healthy pregnant women were as following: TC 4.45–8.99 and 4.83–9.71 mmol/l, HDL 1.33–3.06 and 1.16–3.13 mmol/l, LDL 2.14–6.11 and 2.35–6.98 mmol/l, TG 0.92–3.0 and 1.37–4.76 mmol/l as well as apoB 0.69–1.93 and 0.85–2.21 g/l. Parity and nutrient intake were not significantly associated with changes in lipid concentration. Prematurity was associated with a significant decrease in TC and TG levels.
Detailed reference values for serum lipids and apolipoproteins in pregnancy are now available for a Caucasian cohort. Further, long-term studies are still needed to assess the effect of the extensive concentration changes of serum lipids in pregnancy and their atherogenic risk definitively.
KeywordsLIFE Child Pregnancy Reference data Serum lipids Caucasian cohort
Analysis of variance
- Body mass index
Food frequency questionnaire
Gestational Diabetes Mellitus
High-density lipoprotein cholesterol
Liquid chromatography–mass spectrometry
Low-density lipoprotein cholesterol
Pregnancy associated hypertension
Sex hormone binding globulin
ADS was involved in protocol development, data analysis and writing manuscript. MV was involved in data management and analysis. AJ was involved in protocol development. JT was involved in data collection. WK was involved in project development, data collection and manuscript editing. HS was involved in manuscript editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Informed consent was obtained from all individual participants involved in the study. All subjects gave their written consent for study participation. For participants under the age of 12 years, parents had to give their written consent.
Statement of financial support
This publication is supported by LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany. LIFE is funded by means of the European Union, by the European Regional Development Fund (ERDF) and by means of the Free State of Saxony within the framework of the excellence initiative of the Saxonian Ministry of Science and Arts (SMWK), Free State of Saxony, Germany.
All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 (in its most recently amended version). The study was approved by the Ethical Committee of the University of Leipzig (reference number: Reg. No. 264-10-19042010). LIFE Child is registered by the trial number: NCT02550236.
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