Lípidos en el embarazo

Autores/as

  • María Elena Rodríguez Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina
  • Carolina Gómez Martin Cendia, Concordia, Entre Ríos, Argentina
  • María Inés Argerich Hospital Perrupato San Martin, Mendoza, Argentina
  • Paula Fernández Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
  • Stella Maris Succani Nueva Maternidad Provincial de Córdoba "Brigadier Gral. Juan Bautista Bustos", Córdoba, Argentina
  • Celina Bertona Hospital Universitario, Universidad Nacional de Cuyo, Mendoza, Argentina
  • Lina Capurro Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Gabriela Rovira Hospital Materno Infantil de San Isidro, Provincia de Buenos Aires, Argentina
  • Beatriz Villarroel Parra Hospital de Agudos Vélez Sarsfield y Sanatorio Santa Isabel, Ciudad Autónoma de Buenos Aires, Argentina
  • Patricio Mendes CER, Centro de Endocrinología, Neuquén, Argentina
  • Verónica Kojdamanian Favetto Centro de Educación, Prevención y Atención del paciente con diabetes (CEPA), Pilar, Provincia de Buenos Aires, Argentina
  • Fabián Tedesco Hospital San Martín de Paraná, Entre Ríos, Argentina
  • Cristina Faingold Unidad Asistencial Dr. César Milstein, Ciudad Autónoma de Buenos Aires, Argentina
  • Silvia Gorban Lapertosa Universidad Nacional del Nordeste, Corrientes, Argentina
  • María E. Hermida Hospital Interzonal de Agudos Evita Pueblo Berazategui, Provincia de Buenos Aires, Argentina
  • Alicia Jawerbaum Facultad de Medicina, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires, Argentina
  • Magdalena Rey Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
  • Susana Salzberg Instituto Centenario, Ciudad Autónoma de Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v59i3.1132

Palabras clave:

Lípidos, Colesterol total, Triglicéridos, Diabetes mellitus, Obesidad, hdl-colesterol, LDL-colesterol

Resumen

La evolución de los lípidos durante el embarazo busca aportar ácidos grasos para la formación de membranas, hormonas y los depósitos grasos necesarios para el desarrollo fetal.

Si bien hay muchos estudios que muestran su aumento progresivo desde el final del primer al tercer trimestre, algunos también relacionan estos cambios con la presencia de obesidad podrían ser más importantes. No existe acuerdo sobre los valores que deberían ser considerados normales. Este artículo expone la fisiopatología de su desarrollo, analiza el tipo de tratamiento tanto nutricional como farmacológico.

Biografía del autor/a

María Elena Rodríguez, Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición, especializada en Diabetes, Coordinadora del Comité de Embarazo y Diabetes

Carolina Gómez Martin, Cendia, Concordia, Entre Ríos, Argentina

Médica especialista en Medicina Interna, Universidad de Buenos Aires (UBA), especializada en Diabetes Sociedad Argentina de Diabetes (SAD), Secretaria del Comité de Embarazo y Diabetes (SAD), Codirectora de Cendia

María Inés Argerich, Hospital Perrupato San Martin, Mendoza, Argentina

Médica especialista en Diabetología

Paula Fernández, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina

Médica Internista, especializada en Diabetes, certificada en Obesidad

Stella Maris Succani, Nueva Maternidad Provincial de Córdoba "Brigadier Gral. Juan Bautista Bustos", Córdoba, Argentina

Médica especialista en Medicina Interna y Diabetología, Jefa del Servicio de Clínica Medica de la Nueva Maternidad Provincial de Córdoba "Brigadier Gral. Juan Bautista Bustos"

Celina Bertona, Hospital Universitario, Universidad Nacional de Cuyo, Mendoza, Argentina

Médica Diabetóloga

Lina Capurro, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Endocrinología y Metabolismo, Médica de Planta, Sección Diabetes, Servicio de Endocrinología y Medicina Nuclear

Gabriela Rovira, Hospital Materno Infantil de San Isidro, Provincia de Buenos Aires, Argentina

Médica Endocrinóloga

Beatriz Villarroel Parra, Hospital de Agudos Vélez Sarsfield y Sanatorio Santa Isabel, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición Clínica, Universidad de Buenos Aires (UBA)

Patricio Mendes, CER, Centro de Endocrinología, Neuquén, Argentina

Médico Endocrinólogo, especialista en Nutrición

Verónica Kojdamanian Favetto, Centro de Educación, Prevención y Atención del paciente con diabetes (CEPA), Pilar, Provincia de Buenos Aires, Argentina

Médica especialista en Nutrición y Diabetología, Coordinadora del Centro de Educación, Prevención y Atención del paciente con diabetes (CEPA)

Fabián Tedesco, Hospital San Martín de Paraná, Entre Ríos, Argentina

Médico especialista en Endocrinología y Diabetología, Jefe del Servicio de Endocrinología, Diabetes y Nutrición

Cristina Faingold, Unidad Asistencial Dr. César Milstein, Ciudad Autónoma de Buenos Aires, Argentina

Médica Endocrinóloga, Jefa del Servicio de Endocrinología

Silvia Gorban Lapertosa, Universidad Nacional del Nordeste, Corrientes, Argentina

Médica especialista en Nutrición, Profesora Libre Facultad de Medicina

María E. Hermida, Hospital Interzonal de Agudos Evita Pueblo Berazategui, Provincia de Buenos Aires, Argentina

Médica especialista en Clínica Médica, Magíster en Diabetes, Médica de Planta

Alicia Jawerbaum, Facultad de Medicina, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires, Argentina

Investigadora principal del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Directora del Laboratorio de Reproducción y Metabolismo (Centro de Estudios Farmacológicos y Botánicos, CEFYBO-CONICET)

Magdalena Rey, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina

Médica Endocrinóloga, Médica de Planta

Susana Salzberg, Instituto Centenario, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición y Diabetes, Directora del Departamento de Investigación

Citas

I. Song X, Chen L, Zhang S, Liu Y, Wei J, Wang T, et al. Gestational diabetes mellitus and high triglyceride levels mediate the association between pre-pregnancy overweight/obesity and macrosomia: A prospective cohort study in central China. Nutrients 2022 Aug 16;14(16):3347.

II. Kaur G, Gulati M. Considerations for treatment of lipid disorders during pregnancy and breastfeeding. Prog Cardiovasc Dis 2022 Nov;75:33-9.

III. Arbib N, Pfeffer-Gik T, Sneh-Arbib O, Krispin E, Rosenblat O, Hadar E. The pre-gestational triglycerides and high-density lipoprotein cholesterol ratio is associated with adverse perinatal outcomes. A retrospective cohort analysis. Int J Gynaecol Obstet 2020 Mar;148(3):375-80.

IV. Shi P, Tang J, Yin X. Association between second and third trimester maternal lipid profiles and adverse perinatal outcomes among women with GDM and non-GDM: a retrospective cohort study. BMC Pregnancy Childbirth 2023 May 5;23(1):318.

V. Mauri M, Calmarza P, Ibarretxe D. Dyslipemias and pregnancy, an update. Clin Investig Arterioscler 2021;33(1):41-52.

VI. Delgado-Lista J, Mostaza JM, Arrobas-Velilla T, Blanco-Vaca F, Masana L, Pedro-Botet J, et al. Consenso sobre lipoproteína (a) de la Sociedad Española de Arteriosclerosis. Revisión bibliográfica y recomendaciones para la práctica clínica. Clin Investig Arterioscler 2024 Jul;36(4):243-66.

VII. Mulder JWCM, Kusters DM, Roeters van Lennep JE, Hutten BA. Lipid metabolism during pregnancy: consequences for mother and child. Curr Opin Lipidol 2024 Jun 1;35(3):133-40.

VIII. Piechota W, Staszewski A. Reference ranges of lipids and apolipoproteins in pregnancy. Eur J Obstet Gynecol Reprod Biol 1992 Jun;45(1):27-35.

IX. Gorban de Lapertosa S, Alvariñas J, Elgart JF, Salzberg S, Gagliardino JJ, EduGest group. The triad macrosomia, obesity, and hypertriglyceridemia in gestational diabetes. Diabetes Metab Res Rev 2020 Jul;36(5):e3302.

X. Bashir M, Navti O, Ahmed B, Konje J. Hyperlipidameia and severe hypertriglyceridaemia in pregnancy. The Obstetrician and Gynaecologist 2023;25:196-209.

XI. Cantin C, Fuenzalida B, Leiva A. Maternal hypercholesterolemia during pregnancy: Potential modulation of cholesterol transport through the human placenta and lipoprotein profile in maternal and neonatal circulation. Placenta 2020 May;94:26-33.

XII. Wan Y, Chen Y, Wu X, Yin A, Tian F, Zhang H, et al. Mediation effect of maternal triglyceride and fasting glucose level on the relationship between maternal overweight/ obesity and fetal growth: a prospective cohort study. BMC Pregnancy Childbirth 2023 Jun 16;23(1):449.

XIII. Skytte HN, Roland MCP, Christensen JJ, Holven KB, Lekva T, Gunnes N, et al. Maternal metabolic profiling across body mass index groups. An exploratory longitudinal study. Acta Obstet Gynecol Scand 2024 Mar;103(3):540-50.

XIV. Poornima IG, Indaram M, Ross JD, Agarwala A, Wild RA. Hyperlipidemia and risk for preclampsia. J Clin Lipidol 2022 May;16(3):253-60.

XV. Wiznitzer A, Mayer A, Novack V, Sheiner E, Gilutz H, Malhotra A, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol 2009 Nov;201(5):482.e1-8.

XVI. Aguilar-Cordero MJ, Baena-García L, Sánchez-López AM, Guisado-Barrilao R, Hermoso-Rodríguez E, Mur-Villar N, et al. Triglyceride levels as a risk factor during pregnancy; Biological modeling; Systematic review. Nutr Hosp 2015 Aug 1;32(2):517-27.

XVII. Lee KK, Raja EA, Lee AJ, Bhattacharya S, Bhattacharya S, Norman JE, et al. Maternal obesity during pregnancy associates with premature mortality and major cardiovascular events in later life. Hypertension 2015 Nov;66(5):938-44.

XVIII. Magnussen EB, Vatten LJ, Myklestad K, Salvesen KÅ, Romundstad PR. Cardiovascular risk factors prior to conception and the length of pregnancy: population-based cohort study. Am J Obstet Gynecol 2011 Jun;204(6):526.e1-8.

XIX. Jiang S, Jiang J, Xu H, Wang S, Liu Z, Li M, et al. Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: A meta-analysis. Taiwan J Obstet Gynecol 2017 Feb;56(1):9-15.

XX. Enquobahrie DA, Williams MA, Butler CL, Frederick IO, Miller RS, Luthy DA. Maternal plasma lipid concentrations in early pregnancy and risk of preeclampsia. Am J Hypertens 2004 Jul;17(7):574-81.

XXI. Ferriols E, Rueda C, Gamero R, Vidal M, Payá A, Carreras R, et al. Comportamiento de los lípidos durante la gestación y su relación con acontecimientos obstétricos desfavorables. Clin Investig Arterioscler 2016 Sep;28(5):232-44.

XXII. Schaefer-Graf UM, Graf K, Kulbacka I, Kjos SL, Dudenhausen J, Vetter K, et al. Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus. Diabetes Care 2008 Sep;31(9):1858-63.

XXIII. Pitchumoni CS, Yegneswaran B. Acute pancreatitis in pregnancy. World J Gastroenterol 2009 Dec 7;15(45):5641-6.

XXIV. Mañas-García MD, Marchán-Carranza E, Galiana-Gómez Del Pulgar J, Fernández de Bobadilla Pascual B. Clin Investig Arterioscler 2017 Nov;29(6):275–7.

XXV. Cruciat G, Nemeti G, Goidescu I, Anitan S, Florian A. Hypertriglyceridemia triggered acute pancreatitis in pregnancy - diagnostic approach, management and follow-up care. Lipids Health Dis 2020 Jan 4;19(1):2.

XXVI. Herrera E, Ortega-Senovilla H. Lipid metabolism during pregnancy and its implications for fetal growth. Curr Pharm Biotechnol 2014;15(1):2431.

XXVII. Lewek J, Banach M. Dyslipidemia management in pregnancy: Why is it not covered in the guidelines? Curr Atheroscler Rep 2022 Jul;24(7):547–56.

XXVIII. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS. PCNA guideline on the management of blood colesterol. Executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2018;139(25):e1046-e1e81.

XXIX. Brown HL, Warner JJ, Gianos E, Gulati M, Hill AJ, Hollier LM, et al. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists. A presidential advisory from the American heart association and the American college of obstetricians and gynecologists. Circulation 2018 Jun 12;137(24):e843-52.

XXX. Yamamoto A, McCormick MC, Burris HH. US provider-reported diet and physical activity counseling to pregnant and non-pregnant women of childbearing age during preventive care visits. Matern Child Health J 2014 Sep;18(7):1610-8.

XXXI. Knight M, Foster C. Diet and exercise in pregnancy. BMJ 2017 Jul 19;358:j3283.

XXXII. International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ 2017 Jul 19;358:j3119.

XXXIII. Bashir M, Navti OB, Ahmed B, Konje JC. Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy. Obstet Gynaecol 2023 Jul;25(3):196-209.

XXXIV. Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 2. J Clin Lipidol 2015 Nov;9(6 Suppl):S1-122.e1.

XXXV. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015 Apr;122(5):643-51.

XXXVI. Gupta M, Liti B, Barrett C, Thompson PD, Fernandez AB. Prevention and management of hypertriglyceridemia-induced acute pancreatitis during pregnancy: A systematic review. Am J Med 2022 Jun;135(6):709-14.

XXXVII. Tan SYT, Teh SP, Kaushik M, Yong TT, Durai S, Tien CJC, et al. Hypertriglyceridemia-induced pancreatitis in pregnancy: case review on the role of therapeutic plasma exchange. Endocrinol Diabetes Metab Case Rep 2021 May 1;2021.

XXXVIII. Khoury J, Haugen G, Tonstad S, Frøslie KF, Henriksen T. Effect of a cholesterol-lowering diet during pregnancy on maternal and fetal Doppler velocimetry: the CARRDIP study. Am J Obstet Gynecol 2007 Jun;196(6):549.e1-7.

XXXIX. Goldberg AS, Hegele RA. Severe hypertriglyceridemia in pregnancy. J Clin Endocrinol Metab 2012 Aug;97(8):2589-96.

XL. Mulder J, Kusters DM, Van Lennep R, Hutten JE. Lipid metabolism during pregnancy: consequences for mother and child. Current opinion in Lipidology 2024; 35(3):133-140.

XLI. Higa R, Jawerbaum A. Intrauterine effects of impaired lipid homeostasis in pregnancy diseases. Curr Med Chem. 2013;20(18):2338-50.

XLII. de Lapertosa SG. Consideraciones nutricionales en diabetes pregestacional, gestacional y lactancia. Revista de la Asociación Latinoamericana de Diabetes. 2017 May 7;7:96-104.

XLIII. Publicado por la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) y la Fundación Iberoamericana de Nutrición (FINUT). Granada. España; 2012.

XLIV. Sioen I, van Lieshout L, Eilander A, Fleith M, Lohner S, Szommer A, et al. Systematic review on N-3 and N-6 polyunsaturated fatty acid intake in European countries in light of the current recommendations focus on specific population groups. Ann Nutr Metab 2017 Feb 11;70(1):39-50.

XLV. Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”#. Int J Gynaecol Obstet 2015 Oct;131:S213.

XLVI. Jiang Y, Chen Y, Wei L, Zhang H, Zhang J, Zhou X, et al. DHA supplementation and pregnancy complications. J Transl Med 2023 Jun 17;21(1):394.

XLVII. Leung KS, Galano JM, Durand T, Lee JCY. Profiling of omega-polyunsaturated fatty acids and their oxidized products in salmon after different cooking methods. Antioxidants (Basel) 2018 Jul 24;7(8).

XLVIII. Lăcătușu CM, Grigorescu ED, Floria M, Onofriescu A, Mihai BM. The Mediterranean diet: from an environment-driven food culture to an emerging medical prescription. Int J Environ Res Public Health 2019 Mar 15;16(6):942.

XLIX. Piroddi M, Albini A, Fabiani R, Giovannelli L, Luceri C, Natella F, et al. Nutrigenomics of extra-virgin olive oil: a review. Biofactors 2017 Jan 2;43(1):17-41.

L. Ribot G, Diaz D, Fazio E, Gómez MV, Fornes HL, Macchi D. An extra virgin olive oil-enriched diet improves maternal, placental, and cord blood parameters in GDM pregnancies. Diabetes Metab Res Rev. 2020; 36(8):e3349.

LI. Ribot G, Diaz D, Fazio E, Gómez MV, Careaga HL, Maier V. Metabolic and molecular effects of dietary extra virgin olive oil in blood and placenta of women with GDM. Frontiers in Endocrinology 2023;14.

LII. Nordgren TM, Lyden E, Berry A, Hanson A. Omega-3 fatty acid intake of pregnant women and women of childbearing age in the United States: potential for deficiency? Nutrients. Nutrients 2017;9(3).

LIII. Elshani B, Kotori V, Daci A. Role of omega-3 polyunsaturated fatty acids in gestational diabetes, maternal and fetal insights: current use and future directions. J Matern Fetal Neonatal Med 2021 Jan;34(1):124-36.

LIV. Jacobson TA. Role of n-3 fatty acids in the treatment of hypertriglyceridemia and cardiovascular disease. Am J Clin Nutr 2008 Jun;87(6):1981S-90S.

LV. Skulas-Ray AC, West SG, Davidson MH, Kris-Etherton PM. Omega-3 fatty acid concentrates in the treatment of moderate hypertriglyceridemia. Expert Opin Pharmacother 2008 May;9(7):1237-48.

LVI. Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med 2019 Jan 3;380(1):11-22.

LVII. Group A, Bowman L, Mafham M, Wallendszus K, Stevens W, Buck G. Effects of n-3 fatty acid supplements in diabetes. N Engl J Med 2018;379(16):1540-50.

LVIII. Manson JE, Cook NR, Lee IM, Christen W, Bassuk SS, Mora S, et al. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer. N Engl J Med 2019 Jan 3;380(1):23-32.

LIX. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Libr 2018 Nov 15;2018(11).

LX. Mauri M, Calmarza P, Ibarretxe D. Dislipemias y embarazo, una puesta al día. Clin Investig Arterioscler 2021 Jan;33(1):41-52.

LXI. Banach M, Burchardt P, Chlebus K, Dobrowolski P, Dudek D, Dyrbuś K, et al. PoLA/CFPiP/PCS/PSLD/PSD/PSH guidelines on diagnosis and therapy of lipid disorders in Poland 2021. Arch Med Sci 2021 Nov 8;17(6):1447-547.

LXII. Vahedian-Azimi A, Bianconi V, Makvandi S, Banach M, Mohammadi SM, Pirro M, et al. A systematicreview and meta-analysisontheeffects of statins on pregnancy outcomes. Atherosclerosis 2021;336:1-11.

LXIII. Drugs.com. Medicine use during pregnancy or breastfeeding. Disponible en: www.drugs.com/pregnancy/ (consultado noviembre 2024).

LXIV. Mehta LS, Warnes CA, Bradley E, Burton T, Economy K, Mehran R, et al. Cardiovascular considerations in caring for pregnant patients: A scientific statement from the American heart association. Circulation 2020 Jun 9;141(23):e884-903.

LXV. Bateman BT, Hernández-Díaz S, Fischer MA, Seely EW, Ecker JL, Franklin JM. Statins and congenitalmalformations: Cohortstudy. BMJ 2015;350.

LXVI. Costantine MM, Cleary K, Hebert MF, Ahmed MS, Brown LM, Ren Z, et al. Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial. Am J Obstet Gynecol 2016 Jun;214(6):720.e1-720.e17.

LXVII. McGrogan A, Snowball J, Charlton RA. Statins during pregnancy: a cohort study using the General Practice Research Database to investigate pregnancy loss. Pharmacoepidemiol Drug Saf 2017 Jul;26(7):843-52.

LXVIII. Food and Drug Administration (FDA). Requests removal of strongest warning against using cholesterol-lowering statins during pregnancy; still advises most pregnant patients should stop taking statins. Disponible en: www.fda.gov/drugs/drug-safety-and-availability/fda-requests-removal-strongest-warning-against-using-cholesterol-lowering-statins-during-pregnancy (consultado noviembre 2024).

LXIX. Klevmoen M, Bogsrud MP, Retterstøl K, Svilaas T, Vesterbekkmo EK, Hovland A, et al. Loss of statin treatment years during pregnancy and breastfeeding periods in women with familial hypercholesterolemia. Atherosclerosis 2021 Oct;335:8-15.

LXX. Edison RJ, Muenke M. Mechanistic and epidemiologic considerations in the evaluation of adverse birth outcomes following gestational exposure to statins. Am J Med Genet A 2004 Dec 15;131(3):287-98.

LXXI. Chang J, Chen Y, et al Perinatal outcome after statins exposure during pregnancy. Jama Network Open 2021;(4).

LXXII. Karadas B, Uysal N, Erol H, Acar S, Koc M, Kaya-Temiz T, et al. Pregnancy outcomes following maternal exposure to statins: A systematic review and meta-analysis. Br J Clin Pharmacol 2022 Sep;88(9):3962-76.

LXXIII. Döbert M, Varouxaki AN, Mu AC, Syngelaki A, Ciobanu A, Akolekar R, et al. Pravastatin versus placebo in pregnancies at high risk of term preeclampsia. Circulation. 2021 Aug 31;144(9):670-9.

LXXIV. Kereiakes DJ, Robinson JG, Cannon CP, Lorenzato C, Pordy R, Chaudhari U, et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab among high cardiovascular risk patients on maximally tolerated statin therapy: The ODYSSEY COMBO I study. Am Heart J 2015 Jun;169(6):906-15.e13.

LXXV. Blom DJ, Hala T, Bolognese M. for the DESCARTES Investigators. A 52-week placebo-controlled trial of evolocumab in hyperlipidemia. NEngl J Med 2014;370:1809-19.

LXXVI. Suzuki T, Tsurane K, Umemoto T, Sasano T, Ushiki E, Fudono A, et al. PCSK9 inhibitor use during pregnancy in a case of familial hypercholesterolemia complicated with coronary artery disease. J Obstet Gynaecol Res 2024 Jan;50(1):128-32.

LXXVII. Lewek J, Bielecka-Dąbrowa A, Toth PP, Banach M. Dyslipidaemia management in pregnant patients: a 2024 update. Eur Heart J Open. 2024 May;4(3):oeae032.

LXXVIII. Wild R, Feingold KR. Effect of pregnancy on lipid metabolism and lipoprotein levels. In: Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000.

LXXIX. Basar R, Uzum AK, Canbaz B, Dogansen SC, Kalayoglu-Besisik S, Altay-Dadin S, Aral F, Ozbey NC. Therapeutic apheresis for severe hypertriglyceridemia in pregnancy. Arch Gynecol Obstet 2013 May;287(5):839-43.

LXXX. Syed H, Bilusic M, Rhondla C, Tavaria A. Plasmapheresis in the hypertriglyceridemia-induced acute pancreatitis: a community hospital’s experience. J Clin Apher 2010;25:229-34.

LXXXI. Schuff-Werner P, Fenger S, Kohlschein P. Role of lipid apheresis in changing times. Clin Res Cardiol Suppl 2012 Jun;7(S1):7-14.

LXXXII. Basar R, Uzum AK, Canbaz B, Dogansen SC, Kalayoglu-Besisik S, Altay-Dadin S, et al. Therapeutic apheresis for severe hypertriglyceridemia in pregnancy. Arch Gynecol Obstet 2013 May;287(5):839-43.

LXXXIII. Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, et al. Guidelines on the use of therapeutic apheresis in clinical practice evidence-based approach from the writing committee of the American Society for apheresis: The ninth Special Issue. J Clin Apher 2023 Apr;38(2):77-278.

LXXXIV. Graham DF, Raal FJ. Management of familial hypercholesterolemia in pregnancy. Curr Opin Lipidol 2021 Dec 1;32(6):370-7.

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27-10-2025