RESUMENAntecedentes: En el embarazo se producen variaciones hormonales muy marcadas y estas se asocian con grandes modificaciones del perfil lipídico. Objetivos: Evaluar el perfil lipídico de mujeres adultas por trimestre de gestación y comparar el perfil lipídico de un grupo control de mujeres no embarazadas con gestantes del primer trimestre, que consultan al servicio de Maternidad del Hospital Público Provincial "Dr. Ramón Madariaga". Método: Se estudiaron 248 embarazadas, 69 en primer trimestre, 78 segundo y 101 tercero. Además un grupo control de 43 no gestantes con distribución etárea, índice de masa corporal y criterios de exclusión similares al grupo de gestantes. Se extrajo sangre con 12 horas de ayuno para las determinaciones bioquímicas, las cuales fueron realizadas por métodos enzimáticos colorimétricos, con controles de calidad interno y externo. Resultados: Se encontró que colesterol total, triglicéridos, col-VLDL, col-LDL, los índices colesterol total/col-HDL y triglicéridos/col-HDL, fueron aumentando significativamente en cada trimestre, mientras que el c-HDL no presentó diferencias. Los valores de percentilo 95 del tercer trimestre para CT de 321 mg/dl y TG 371 mg/dl, podrían ser utilizados como valores de corte en nuestra población. Cuando se comparó mujeres no gestantes versus embarazadas del primer trimestre no se encontraron cambios significativos. Conclusiones: El seguimiento del perfil lipídico de las gestantes podría convertirse en una herramienta diagnóstica que permita monitorear aumentos que superen lo considerado como fisiológico, llevando a un adecuado control prenatal.
PALABRAS CLAVE: Riesgo aterogénico, embarazo, perfil lipídico
SUMMARY
Background:In pregnancy hormonal changes occur very marked and these are associated with major changes in the lipid profile. Aims: To evaluate the lipid profile of adult women during normal pregnancy in the first, second and third trimester and to compare the lipid profile of woman who are not pregnant with the lipid profile of woman who are in the first trimester of gestation and who are attended at the Maternity Public and Provincial Hospital "Dr. Ramón Madariaga". Methods: 248 pregnant women were evaluated of which: 69 women were in the first trimester; 78 women were in the second trimester and 101 women were in the third trimester. In addition a control group of 43 non-pregnant women with age distribution, body mass index and exclusion criteria similar to the group of pregnant women. Blood was extracted after twelve hours fasting to get the biochemical determinations which results were gotten by enzymatic colorimetric methods, with internal and external quality control. Results: It was found that total cholesterol; triglycerides, very low density and low density lipoprotein, the total cholesterol index/ high density lipoprotein y triglycerides/ high
Background
Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown.
Methods
We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor.
Results
Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana.
Interpretation
RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries.
Funding
Wellcome Trust (214185/Z/18/Z)
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