Does Pregnancy Affect Lipid Metabolism? Elevated TG and Cholesterol

Can pregnancy cause lipid metabolism disorders?

Hello: During pregnancy, I have been supplementing with a multivitamin and algal DHA, and my dietary habits have not changed significantly (similar to before pregnancy).
I often eat out, but I do not frequently consume high-fat meats or sweets.
Since I live in the mountains, my meat intake mainly consists of poultry and livestock, and I pay attention to maintaining a balanced diet with vegetables and fruits, consuming approximately 2-2.5 servings of vegetables and 1-2 servings of fruits daily.
Before pregnancy, all my routine biochemical tests were normal, but at four months pregnant, blood tests revealed a triglyceride (TG) level of 215 mg/dL, exceeding the normal value of 160 mg/dL.
Cholesterol was normal at 141 mg/dL, with LDL at 83 and HDL at 42.
Other tests, including glucose, GOT, GPT, BUN, and creatinine, were normal.
At about seven months pregnant, another blood test showed that TG had risen to 361 mg/dL, cholesterol had increased to 203 mg/dL, LDL had risen to 126, and HDL to 46.
I would like to know if the increase in TG and cholesterol is due to hormonal changes during pregnancy.
Does pregnancy affect lipid metabolism, or could it be a dietary issue? There are reports indicating that fish oil can lower TG levels, but why do TG levels continue to rise?

cc, 30~39 year old female. Ask Date: 2005/04/25

Dr. Shi Guimei reply Nutrition

Hello! During pregnancy, hormonal changes can indeed affect lipid metabolism, so the ideal levels of cholesterol and triglycerides during pregnancy are slightly higher than those for the general adult population (where both ideal levels are typically below 200 mg/dL).
However, your triglyceride level has risen to 361 mg/dL, which is considered abnormal.

In terms of diet, it is advisable to follow a normal eating pattern while avoiding refined sweets, sugary beverages, and other added sugar products.
Fried, greasy, and baked foods should also be minimized.
If a manufacturer claims that their fish oil product has therapeutic effects, such as lowering cholesterol or triglycerides, that product must be certified as a health food by the Department of Health to ensure its quality and efficacy.
However, the safety of fish oil for pregnant women has not been established, so it is generally not recommended for use by pregnant women or those who may become pregnant.
The dietary information you provided is quite limited, but it is clear that you should increase your vegetable intake.
To better assess whether there are other dietary issues or adjustments needed, it would be helpful to provide a 3 to 7-day food diary for the nutritionist's reference (preferably describing food intake by weight), which would assist in analyzing your dietary habits.
Sincerely,
Shih Kuei-Mei, Director of the Nutrition Department, Taoyuan Hospital, Department of Health.

Reply Date: 2005/04/25

More Info

Pregnancy is a unique physiological state that significantly alters various metabolic processes in the body, including lipid metabolism. The changes in triglycerides (TG) and cholesterol levels during pregnancy are primarily influenced by hormonal fluctuations, particularly the increase in estrogen and progesterone. These hormones play a crucial role in preparing the body for the growing fetus, and they also affect how the body processes fats.

During pregnancy, the body undergoes a natural increase in lipid levels. This is partly due to the increased demand for energy and the need to supply essential fatty acids to the developing fetus. The placenta produces hormones that stimulate the liver to produce more lipoproteins, which can lead to elevated levels of triglycerides and cholesterol. It is common for pregnant women to experience higher levels of these lipids, and the normal reference ranges for lipid levels during pregnancy are often higher than those for non-pregnant individuals.

In your case, the initial triglyceride level of 215 mg/dl at four months of pregnancy, which increased to 361 mg/dl by seven months, is indeed above the normal range. While the cholesterol levels also rose, they remain within a range that is often considered acceptable during pregnancy. The increase in triglycerides can be attributed to the hormonal changes associated with pregnancy, which enhance fat storage and alter lipid metabolism.
Dietary factors can also play a role in lipid levels. Although you mentioned maintaining a balanced diet with a focus on vegetables and fruits, it is important to consider the overall caloric intake and the types of fats consumed. Even if high-fat meats and sweets are consumed infrequently, the cumulative effect of dietary habits can influence lipid levels. Additionally, the intake of omega-3 fatty acids, such as those found in fish oil, is known to help lower triglyceride levels. However, if the overall dietary fat intake is high or if there are other underlying metabolic factors, the beneficial effects of fish oil may not be sufficient to counteract the increases in triglycerides.

It is also worth noting that some women may have a predisposition to elevated triglycerides during pregnancy due to genetic factors or pre-existing conditions such as polycystic ovary syndrome (PCOS), which can affect lipid metabolism. If you have a history of lipid abnormalities prior to pregnancy, this may also contribute to the observed increases.

In conclusion, the elevation of triglycerides and cholesterol during pregnancy is primarily due to hormonal changes that affect lipid metabolism. While dietary habits do play a role, the physiological changes during pregnancy are significant and can lead to elevated lipid levels even in women who maintain a relatively healthy diet. It is advisable to monitor these levels regularly and consult with a healthcare provider for personalized dietary recommendations and management strategies to ensure both maternal and fetal health. If triglyceride levels continue to rise or if there are concerns about potential complications, further evaluation and intervention may be necessary.

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