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The Comparation between Lipid Plasma Profile of Preeclampsia and Normotensive Pregnancy (Perbandingan Profil Lemak antara Kehamilan Preeklampsia dan Kehamilan Normotensif)
Objective : To study the lipid plasma profile of preeclampsia and normotensive pregnancy as an additional information in explaining the pathogenesis of preeclampsia. Design/data identification : Clinical, analitycal, cross sectional and prospective study. Setting : 1) Department of Obstetrics and Gynecology Dr. Soetomo Hospital/Medical School, Airlangga University, for taking the venous blood samples. 2) Department of Obstetrics and Gynecology, Kobe University, School of Medicine, Japan, for conducting the laboratory examination. Subject, patients, participations : 60 cases of second and third trimester pregnant mothers were divided into two groups. The first group consists of 39 cases of severe preeclampsia and the second group consists of 21 cases of normotensive pregnant mothers. Intervention was needed except for the standardized therapeutic regimen for severe preeclampsia. Main outcome measures : 1) The plasma level of total cholesterol, total triglyceride, free fatty acid, unsaturated and saturated fatty acid. 2) The plasma level of lipoprotein : HDL cholesterol, LDL cholesterol and lipoprotein alpha 3) HDL, cholesterol and total cholesterol ratio. 4) Atherogenic index in preeclampsia and normotensive pregnant women. Results : 1) Total cholesterol (249.0 plus/minus 53.0 mg/dl) and total triglyceride (253.0 plus/minus 92.2 mg/dl) in normotensive and preeclampsia is higher compared to total cholesterol and total triglyceride outside pregnancy. Total cholesterol in preeclampsia increased 13.18 percent compared to total cholesterol outside pregnancy, while total triglyceride in preeclampsia increased 68.66 percent compared to total triglyceride outside pregnancy. Total cholesterol in preeclampsia (236.6 plus/minus 52.2 mg/dl) is significantly lower compared to normotensive pregnancy, but total triglyceride (322 plus/minus 115 mg/dl) is significantly higher compared to normotensive pregnancy. Saturated fatty acid in preeclampsia (37.01 plus/minus 2.56 mg/dl) is significantly higher compared to saturated fatty acid in normotensive pregnancy (34.47 plus/minus 2 mg/dl). Unsaturated fatty acid in preeclampsia (62.76 plus/minus 2.39 mg/dl) is significantly higher compared to unsaturated fatty acid in normotensive pregnancy (65.05 plus/minus 1.99 mg/dl). 2) HDL cholesterol in preeclampsia (39.2 plus/minus 15.2 mg/dl) is significantly lower compared to HDL cholesterol in normotensive pregnancy (52.4 plus/minus 14.5 mg/dl). LDL cholesterol in preeclampsia (133.2 plus/minus 41.3 mg/dl) is not significantly lower comp-ared to LDL cholesterol normotensive pregnancy (144.5 plus/minus 39.3 mg/dl). Lipoprotein alpha in preeclampsia (19.8 plus/minus 16.3 mg/dl) is not significantly higher compared to lipoprotein alpha in normotensive pregnancy (13.33 plus/minus 9.10 mg/dl), but it is higher compared to lipoprotein alpha outside pregnancy (3.05 mg/dl). 3) HDL cholesterol/total cholesterol ratio in preeclampsia compared to HDL cholesterol/total cholesterol ratio in preeclampsia compared to HDL cholesterol/total cholesterol ratio in normotensive pregnancy is 16 percent and 21 percent. 4) Atherogenic index in preeclampsia (5.39 plus/minus 1.92 mg/dl) is significantly higher compared to normotensive pregnancy (3.85 plus/minus 1.26 mg/dl). Conclusions : Both plasma total cholesterol, and total triglyceride, increased in preeclampsia and normotensive pregnant women compared to plasma level of nonpregnant adult women. These facts strongly suggest that in preeclampsia and normotensive pregnant women is actually a state of hyperlipidemia. Total cholesterol in preeclampsia is not significantly lower compared to normotensive, but total triglyceride is significantly higher compared to normotensive pregnacy. The results of this study also revealed that preeclampsia is an atherogenic state compared to normotensive pregnant women, based on the figures of atherogenic index and HDL cholesterol/total cholesterol ratio. All of this findings are expected to contribute as an additional basic knowledge for more preeclampsia to the pathogenesis of preeclampsia.
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