title: The impact of preconceptional obesity on trajectories of maternal lipids during gestation.
abstract: Growing challenges of maternal obesity necessitate to focus metabolic management on alternative factors than glycaemia. The objective is to assess longitudinal changes in lipids and inflammatory parameters during pregnancies stratified by pregestational BMI. Therefore, 222 pregnant women (normal-weight BMI < 25: n = 91 (41%), overweight BMI 25-29.9: n = 69 (31%), obese BMI ≥ 30: n = 62 (28%)) underwent a detailed metabolic characterization including fasting lipids and glucometabolic parameters at <21(st) gestational week (GW) with follow-up assessments at further three visits (24-28(th) GW, 32-34(th) GW, >36(th) GW). Overweight and obesity was related to dyslipidemia already at baseline, i.e. elevated triglycerides (TG, p < 0.001), decreased high-density-lipoprotein-C (p = 0.009) and increased ultrasensitive-c-reactive-protein (usCRP, p < 0.001) independent of gestational diabetes prevalence. Trajectories of lipids during pregnancy progress revealed an unexpected less pronounced increase in TG, low-density-lipoprotein-C and total-cholesterol in overweight/obese women. usCRP remained associated with higher BMI throughout pregnancy showing no time-dependent longitudinal changes. Newborns of obese/overweight women were affected by higher birth-weight percentiles. Regarding lipids only maternal TG showed tendency for relation to prevalence of large-for-gestational-age offspring, particularly at the end of pregnancy (p = 0.048). Overweight and obese women show significant differences in trajectories of lipids during pregnancy that distinguish them from normal-weight women. Further studies should evaluate if targeting lipid metabolism could improve clinical management of maternal obesity.
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Latife
authors.initials: L
authors.lastname: Bozkurt
authors.affiliation: Department of Obstetrics and Gynecology, Division of Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian S
authors.initials: CS
authors.lastname: Göbl
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Anna-Theresa
authors.initials: AT
authors.lastname: Hörmayer
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
authors.affiliation: Metabolic Unit, Institute of Neuroscience, National Research Council, Padova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pacini
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D000328:Adult; D015415:Biomarkers; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005865:Gestational Age; D006801:Humans; D018836:Inflammation Mediators; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000378:metabolism*; D050177:Overweight / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D007328:Insulin; D008055:Lipids