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Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics

European Journal of Clinical Nutrition volume 65, pages 580–589 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

Lipid disturbances during pregnancy may lead to early onset of metabolic diseases in the offspring. However, there is little knowledge on ethnic differences in lipid levels during pregnancy. We evaluated ethnic differences in non-fasting total cholesterol (TC) and triglyceride (TG) levels during early gestation and the role of demographics, behavioural factors and clinical characteristics.

Subjects/Methods:

Non-diabetic pregnant women (N=3025) from the Amsterdam Born Children and their Development (ABCD) study. The studied ethnic groups were Dutch, Surinam-Hindustani, African-Caribbean, Turkish, Moroccan and Ghanaian. A multilingual questionnaire was used to gather information on maternal demographics, behavioural factors and clinical characteristics. Non-fasting TC, TG, percentage saturated fatty acid (%SFA) and percentage linoleic acid status (%LA) were assessed in blood samples collected at the first antenatal visit.

Results:

Ghanaian (−0.51 mmol/l), African-Caribbean (−0.19 mmol/l) and Moroccan (−0.15 mmol/l) women had significant lower TC levels compared with Dutch women. TG levels were lower in Ghanaian (log transformed −0.12 mmol/l) but significantly higher in Surinam-Hindustani (0.10 mmol/l) and Turkish women (0.07 mmol/l). Age, physical activity, pre-pregnancy body mass index (BMI), smoking, %SFA and %LA were independently related to TC and/or TG. However, only pre-pregnancy BMI could partly explain observed disparities. Furthermore, pre-pregnancy BMI had a relatively large effect on TG levels in Surinam-Hindustani and Turkish women.

Conclusions:

TC and TG levels differed between ethnic groups during early gestation. Only pre-pregnancy BMI partly explained the ethnic differences to a relevant degree. Reduction in BMI before pregnancy may improve lipid profile, especially in Surinam-Hindustani and Turkish women.

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References

  • Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ et al. (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32, S498–S516.

    Article  CAS  Google Scholar 

  • Bhalodkar NC, Blum S, Rana T, Kitchappa R, Bhalodkar AN, Enas EA (2005). Comparison of high-density and low-density lipoprotein cholesterol subclasses and sizes in Asian Indian women with Caucasian women from the Framingham Offspring Study. Clin Cardiol 28, 247–251.

    Article  Google Scholar 

  • Bower JF, Vadlamudi S, Barakat HA (2002). Ethnic differences in in vitro glyceride synthesis in subcutaneous and omental adipose tissue. Am J Physiol Endocrinol Metab 283, E988–E993.

    Article  CAS  Google Scholar 

  • Brizzi P, Tonolo G, Esposito F, Puddu L, Dessole S, Maioli M et al. (1999). Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol 181, 430–434.

    Article  CAS  Google Scholar 

  • Canoy D, Wareham N, Luben R, Welch A, Bingham S, Day N et al. (2006). Serum lipid concentration in relation to anthropometric indices of central and peripheral fat distribution in 20,021 British men and women: results from the EPIC-Norfolk population-based cohort study. Atherosclerosis 189, 420–427.

    Article  CAS  Google Scholar 

  • Cappuccio FP (1997). Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin. J Hum Hypertens 11, 571–576.

    Article  CAS  Google Scholar 

  • Carroll JF, Chiapa AL, Rodriquez M, Phelps DR, Cardarelli KM, Vishwanatha JK et al. (2008). Visceral fat, waist circumference, and BMI: impact of race/ethnicity. Obesity 16, 600–607.

    Article  Google Scholar 

  • Daryani A, Becker W, Vessby B, Andersson A (2005a). Dietary fat intake, fat sources and fatty acid composition in serum among immigrant women from Iran and Turkey compared with women of Swedish ethnicity. Scand J Nutr 49, 106–115.

    Article  Google Scholar 

  • Daryani A, Berglund L, Andersson A, Kocturk T, Becker W, Vessby B (2005b). Risk factors for coronary heart disease among immigrant women from Iran and Turkey, compared to women of Swedish ethnicity. Ethn Dis 15, 213–220.

    Google Scholar 

  • Daryani A, Kocturk T, Andersson A, Karlström B, Vessby B, Becker W (2006). Reported macronutrient intake and metabolic risk factors: immigrant women from Iran and Turkey compared with native Swedish women. Scand J Food Nutr 50, 166–172.

    Article  Google Scholar 

  • Desoye G, Schweditsch MO, Pfeiffer KP, Zechner R, Kostner GM (1987). Correlation of hormones with lipid and lipoprotein levels during normal pregnancy and postpartum. J Clin Endocrinol Metab 64, 704–712.

    Article  CAS  Google Scholar 

  • Despres JP, Couillard C, Gagnon J, Bergeron J, Leon AS, Rao DC et al. (2000). Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women—the health, risk factors, exercise training, and genetics (HERITAGE) family study. Arterioscler Thromb Vasc Biol 20, 1932–1938.

    Article  CAS  Google Scholar 

  • Diaz VA, Mainous AG, Koopman RJ, Carek PJ, Geesey ME (2005). Race and diet in the overweight: association with cardiovascular risk in a nationally representative sample. Nutrition 21, 718–725.

    Article  Google Scholar 

  • Edison RJ, Berg K, Remaley A, Kelley R, Rotimi C, Stevenson RE et al. (2007). Adverse birth outcome among mothers with low serum cholesterol. Pediatrics 120, 723–733.

    Article  Google Scholar 

  • Enquobahrie DA, Williams MA, Butler CL, Frederick IO, Miller RS, Luthy DA (2004). Maternal plasma lipid concentrations in early pregnancy and risk of preeclampsia. Am J Hypertens 17, 574–581.

    Article  CAS  Google Scholar 

  • Gentles D, Metcalf P, Dyall L, Scragg R, Sundborn G, Schaaf D et al. (2007). Serum lipid levels for a multicultural population in Auckland, New Zealand: results from the Diabetes Heart and Health Survey (DHAH) 2002-2003. N Z Med J 120, U2800.

    PubMed  Google Scholar 

  • Godsland IF, Johnston DG, Chaturvedi N (2007). Mechanisms of disease: lessons from ethnicity in the role of triglyceride metabolism in ischemic heart disease. Nat Clin Pract Endocrinol Metab 3, 530–538.

    Article  CAS  Google Scholar 

  • Goedhart G, van Eijsden M, van der Wal MF, Bonsel GJ (2008a). Ethnic differences in preterm birth and its subtypes: the effect of a cumulative risk profile. Bjog-An Int J Obstet Gynaecol 115, 710–719.

    Article  CAS  Google Scholar 

  • Goedhart G, van EM, van der Wal MF, Bonsel GJ (2008b). Ethnic differences in term birthweight: the role of constitutional and environmental factors. Paediatr Perinat Epidemiol 22, 360–368.

    Article  Google Scholar 

  • Herrera E (2002). Lipid metabolism in pregnancy and its consequences in the fetus and newborn. Endocrine 19, 43–55.

    Article  CAS  Google Scholar 

  • Howard BV, Ruotolo G, Robbins DC (2003). Obesity and dyslipidemia. Endocrinol Metab Clin North Am 32, 855–867.

    Article  CAS  Google Scholar 

  • Kelley GA, Kelley KS, Tran ZV (2004). Aerobic exercise and lipids and lipoproteins in women: a meta-analysis of randomized controlled trials. J Womens Health 13, 1148–1164.

    Article  Google Scholar 

  • Koklu E, Kurtoglu S, Akcakus M, Koklu S, Buyukkayhan D, Gumus H et al. (2006). Increased aortic intima-media thickness is related to lipid profile in newborns with intrauterine growth restriction. Horm Res 65, 269–275.

    CAS  PubMed  Google Scholar 

  • Koukkou E, Watts GF, Mazurkiewicz J, Lowy C (1994). Ethnic-differences in lipid and lipoprotein metabolism in pregnant-women of African and Caucasian origin. J Clin Pathol 47, 1105–1107.

    Article  CAS  Google Scholar 

  • Lamon-Fava S, Barnett JB, Woods MN, McCormack C, McNamara JR, Schaefer EJ et al. (2005). Differences in serum sex hormone and plasma lipid levels in Caucasian and African-American premenopausal women. J Clin Endocrinol Metab 90, 4516–4520.

    Article  CAS  Google Scholar 

  • McAdams MA, Van Dam RM, Hu FB (2007). Comparison of self-reported and measured BMI as correlates of disease markers in US adults. Obesity 15, 188–196.

    Article  Google Scholar 

  • Millen BE, Franz MM, Quatromoni PA, Gagnon DR, Sonnenberg LM, Ordovas JM et al. (1996). Diet and plasma lipids in women .1. Macronutrients and plasma total and low-density lipoprotein cholesterol in women: the Framingham nutrition studies. J Clin Epidemiol 49, 657–663.

    Article  CAS  Google Scholar 

  • Napoli C, D’Armiento FP, Mancini FP, Postiglione A, Witztum JL, Palumbo G et al. (1997). Fatty streak formation occurs in human fetal aortas and is greatly enhanced by maternal hypercholesterolemia—intimal accumulation of low density lipoprotein and its oxidation precede monocyte recruitment into early atherosclerotic lesions. J Clin Invest 100, 2680–2690.

    Article  CAS  Google Scholar 

  • Napoli C, Glass CK, Witztum JL, Deutsch R, D’Armiento FP, Palinski W (1999). Influence of maternal hypercholesterolaemia during pregnancy on progression of early atherosclerotic lesions in childhood: Fate of Early Lesions in Children (FELIC) study. Lancet 354, 1234–1241.

    Article  CAS  Google Scholar 

  • Radloff LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1, 385–400.

    Article  Google Scholar 

  • Razay G, Heaton KW, Bolton CH, Hughes AO (1992). Alcohol-consumption and its relation to cardiovascular risk-factors in British women. Br Med J 304, 80–83.

    Article  CAS  Google Scholar 

  • Reimann M, Schutte AE, Schwarz PEH (2007). Insulin resistance - the role of ethnicity: evidence from Caucasian and African cohorts. Horm Metab Res 39, 853–857.

    Article  CAS  Google Scholar 

  • Sattar N, Greer IA, Galloway PJ, Packard CJ, Shepherd J, Kelly T et al. (1999). Lipid and lipoprotein concentrations in pregnancies complicated by intrauterine growth restriction. J Clin Endocrinol Metab 84, 128–130.

    CAS  PubMed  Google Scholar 

  • Sattar N, Greer IA, Louden J, Lindsay G, McConnell M, Shepherd J et al. (1997). Lipoprotein subfraction changes in normal pregnancy: threshold effect of plasma triglyceride on appearance of small, dense low density lipoprotein. J Clin Endocrinol Metab 82, 2483–2491.

    CAS  PubMed  Google Scholar 

  • Seidell JC, Perusse L, Despres JP, Bouchard C (2001). Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study. Am J Clin Nutr 74, 315–321.

    Article  CAS  Google Scholar 

  • Skilton MR (2008). Intrauterine risk factors for precocious atherosclerosis. Pediatrics 121, 570–574.

    Article  Google Scholar 

  • Snijder MB, Zimmet PZ, Visser M, Dekker JM, Seidell JC, Shaw JE (2004a). Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study. Int J Obes 28, 402–409.

    Article  CAS  Google Scholar 

  • Snijder MB, Zimmet PZ, Visser M, Dekker JM, Seidell JC, Shaw JE (2004b). Independent association of hip circumference with metabolic profile in different ethnic groups. Obes Res 12, 1370–1374.

    Article  Google Scholar 

  • Sonnenberg LM, Quatromoni PA, Gagnon DR, Cupples LA, Franz MM, Ordovas JM et al. (1996). Diet and plasma lipids in women .2. Macronutrients and plasma triglycerides, high-density lipoprotein, and the ratio of total to high density lipoprotein cholesterol in women: the Framingham nutrition studies. J Clin Epidemiol 49, 665–672.

    Article  CAS  Google Scholar 

  • Stronks K, Kulu-Glasgow I, Agyemang C (2009). The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience. Ethn Health 14, 1–14.

    Article  Google Scholar 

  • Taylor GO, Albers JJ, Warnick GR, Adolphson JL, Mc Farlane H, Sullivan DR et al. (1987). Studies of lipoprotein and fatty-acids in maternal and cord blodd of 2 racial groups in Trinidad. Lipids 22, 173–177.

    Article  CAS  Google Scholar 

  • van Eijsden M, Hornstra G, van der Wal MF, Vrijkotte TGM, Bonsel GJ (2008). Maternal n-3, n-6, and trans fatty acid profile early in pregnancy and term birth weight: a prospective cohort study. Am J Clin Nutr 87, 887–895.

    Article  CAS  Google Scholar 

  • vandenElzen HJ, Wladimiroff JW, CohenOverbeek TE, deBruijn AJ, Grobbee DE (1996). Serum lipids in early pregnancy and risk of pre-eclampsia. Br J Obstet Gynaecol 103, 117–122.

    Article  CAS  Google Scholar 

  • Willett W, Hennekens CH, Castelli W, Rosner B, Evans D, Taylor J et al. (1983). Effects of cigarette-smoking on fasting triglyceride, total cholesterol, and HDL-cholesterol in women. Am Heart J 105, 417–421.

    Article  CAS  Google Scholar 

  • Woollett LA (2005). Maternal cholesterol in fetal development: transport of cholesterol from the maternal to the fetal circulation. Am J Clin Nutr 82, 1155–1161.

    Article  CAS  Google Scholar 

  • Zoratti R (1998). A review on ethnic differences in plasma triglycerides and high-density-lipoprotein cholesterol: is the lipid pattern the key factor for the low coronary heart disease rate in people of African origin? Eur J Epidemiol 14, 9–21.

    Article  CAS  Google Scholar 

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Acknowledgements

We are grateful to all participating hospitals, obstetric clinics and GPs for their assistance in the implementation of the ABCD study. We thank all the participated pregnant women for their co-operation. We thank D Bijlenga for her statistical advice, JSL de Munter for his help with calculating MET scores and Professor K Stronks for her critical comments on the manuscript. Financial support for the Amsterdam Born Children and their Development study was granted by the Netherlands Organisation for Health Research and Development (ZonMw), The Hague. Dr ThB Twickler is financially supported by the Netherlands association of medical science (NWO-ZonMW).

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Authors and Affiliations

  1. Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    Y J Schreuder & T G M Vrijkotte

  2. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    B A Hutten

  3. Department of Epidemiology, Documentation and Health Promotion, Amsterdam, The Netherlands

    M van Eijsden

  4. Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    E H Jansen

  5. Department of Vascular Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    M N Vissers & M T Twickler

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  1. Y J Schreuder
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Correspondence to T G M Vrijkotte.

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Details of Ethics Approval

Approval for the ABCD study was obtained from the Central Committee on Research involving Human Subjects (CCMO; number P02.0335L, 2002), the Medical Ethical Committees of participating hospitals and the Registration Committee of Amsterdam.

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Schreuder, Y., Hutten, B., van Eijsden, M. et al. Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics. Eur J Clin Nutr 65, 580–589 (2011). https://doi.org/10.1038/ejcn.2010.282

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