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Total cholesterol and leptin concentrations are associated with prospective changes in systemic blood pressure in healthy pregnant women

Farias, Dayana R.a,b; Franco-Sena, Ana B.a,b; Rebelo, Fernandaa,c; Schlüssel, Michael M.a; Salles, Gil F.d; Kac, Gilbertoa

doi: 10.1097/HJH.0000000000000037

Background: Lipids and leptin have been associated with high blood pressure (BP) levels during pregnancy. The aim was to evaluate the associations between serum lipids and leptin concentrations during the first trimester and longitudinal changes of SBP and DBP in healthy pregnancies.

Methods: Prospective cohort of pregnant women followed at a public healthcare center in Rio de Janeiro, Brazil. SBP and DBP were obtained at the ≤13th, 20–26th, and 30–36th weeks of gestation and were the dependent variables. Serum lipids and plasma leptin concentrations were collected at 13 weeks or less of gestation and were the main independent variables. Statistical analyses included longitudinal linear mixed-effects regression models, with (β) coefficients and their 95% confidence intervals (CI).

Results: Mean BPs were 109.8/66.9, 107.8/64.3, and 111.2/66.9 mmHg, respectively in the 1st, 2nd, and 3rd trimester. Multiple longitudinal regressions revealed that leisure time physical activity before pregnancy (βSBP = −3.003, 95% CI = −5.034 to −0.971; βDBP = −2.620, 95% CI = −4.177 to −1.064), baseline BMI (βSBP = 4.003, 95% CI = 1.924–6.081; βDBP = 1.862, 95% CI = 0.252–3.412), parity (βSBP = −2.778, 95% CI = −4.627 to −0.929; βDBP = −1.780, 95% CI = −3.168 to −0.392), and Homeostasis model of assessment-Insulin Resistance (HOMA-IR; βSBP = 2.554, 95% CI = 0.552–4.557; βDBP = 2.962, 95% CI = 1.436–4.489) were the covariates independently associated with SBP and DBP changes. Monthly per-capita family income (βSBP = −0.006, 95% CI = −0.010 to −0.001), total cholesterol (βSBP = 2.094, 95% CI = 0.223–3.965), and leptin (βSBP = 2.211, 95% CI = 0.159–4.263) were associated only with SBP changes.

Conclusion: Serum total cholesterol and leptin concentrations, HOMA-IR, and BMI were positively associated with changes in BP during healthy pregnancies, whereas physical activity, parity, and family income were negatively associated.

aNutritional Epidemiology Observatory, Department of Social and Applied Nutrition

bGraduate Program in Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro

cGraduate Program in Epidemiology in Public Health, National School of Public Health, Oswaldo Cruz Foundation

dDepartment of Internal Medicine, University Hospital Clementino Fraga Filho, Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Correspondence to Professor Gilberto Kac, Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J2. Cidade Universitária, Ilha do Fundão. Rio de Janeiro, RJ - 21941-902, Brazil. Tel: +55 21 25626595; fax: +55 21 22808343; e-mail:

Abbreviations: BP, blood pressure; CIs, confidence intervals; HDL-C, high-density lipoprotein cholesterol; HDP, hypertensive disorders of pregnancy; HOMA-IR, Homeostasis model assessment-Insulin Resistance; LDL-C, low-density lipoprotein cholesterol; LME, linear mixed-effects; LTPA, leisure time physical activity; TC, total cholesterol

Received 10 June, 2013

Revised 10 June, 2013

Accepted 5 October, 2013

The preliminary analyses of the data were presented at the Experimental Biology 2013 and published as an abstract in The Journal of the Federation of American Societies for Experimental Biology: Kac G, Farias DR, Franco-Sena FS, Pinto TJP, Vaz JS. Leptin and lipids serum concentration on early pregnancy and 2nd and 3rd trimester blood pressure levels: a prospective cohort study in Rio de Janeiro, Brazil. FASEB J 2013; 27:366

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