Maternal and fetal serum lipid and lipoprotein concentrations and compositions in type 1 diabetic pregnancy: relationship with maternal glycemic control.

摘要

The aim of this study was to determine maternal and fetal lipoprotein profiles in type 1 diabetic pregnancies differing in glycemic control. Serum lipid, apolipoprotein, and lipoprotein lipid concentrations were investigated in mothers with poorly controlled or well-controlled type 1 diabetes as reflected by hemoglobin A1c(HbA1c) concentrations performed by isolab column chromatography and in their macrosomic (body wt = 4650 +/- 90 g) or appropriate-for-gestational-age newborns (body wt = 3616 +/- 68 g), and these levels were compared with those in healthy mothers and in their control newborns (body wt = 3290 +/- 45 g). In mothers with well-controlled diabetes and in their infants, serum lipid, apolipoprotein, and lipoprotein lipid concentrations were comparable to those in control mothers and in their control newborns. Mothers with poorly controlled diabetes presented higher serum triglyceride and apoprotein B-100 (apo B-100) levels but lower apo A-I and HDL3 cholesterol and phospholipid levels as compared with control values. In their macrosomic newborns, all serum lipid, apolipoprotein, and lipoprotein lipid levels were higher than those in control newborns. Maternal HbA1c and triglyceride levels in late gestation were significant predictors of fetal lipids and lipoproteins in the poorly controlled diabetes group. In conclusion, when under good metabolic control, type 1 diabetes did not affect maternal and fetal lipid levels. However, when under poor metabolic control, type 1 diabetes is associated with maternal and fetal lipoprotein abnormalities.