{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:00:09Z","timestamp":1753891209781,"version":"3.41.2"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>This study aims to investigate the efficacy of insulin in treating severe hypertriglyceridaemia (HTG) during the third trimester of pregnancy. Women with severe HTG (TG \u2265 11.30 mmol\/L) in the third trimester of pregnancy who received clinical examination and delivered in Hubei Maternal and Child Health Hospital from 01 January 2017 to 30 September 2021 were recruited. Patients with TG \u2265 11.30 mmol\/L at 30\u201332 weeks of gestation were treated with a low-fat diet and insulin as the insulin treatment group. For the control group, patients with TGs of 5.65\u201311.30 mmol\/L at 30\u201332 weeks of gestation who developed severe HTG (TG \u2265 11.30 mmol\/L) before delivery were treated with a low-fat diet only. General maternal information, delivery, perinatal treatment and laboratory examination information were collected from electronic medical records and compared. We found that in the insulin treatment group, there were higher values of progestational body mass index (BMI) (Z = \u22122.281, <jats:italic>P<\/jats:italic> = 0.023), higher incidence of diabetes (\u03c7<jats:sup>2<\/jats:sup> = 20.618, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and higher incidence of fatty liver (\u03c7<jats:sup>2<\/jats:sup> = 4.333, <jats:italic>P<\/jats:italic> = 0.037) than in the control group but also a higher pregnancy weight gain compliance rate (\u03c7<jats:sup>2<\/jats:sup> = 4.061, <jats:italic>P<\/jats:italic> = 0.044). Laboratory examination before delivery revealed that compared with the control group, insulin treatment significantly decreased prenatal TG (Z = \u221210.392, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), cholesterol (Z = \u22128.494, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), low-density lipoprotein (Z = \u22123.918, P &amp;lt; 0.001), apolipoprotein A1 (t = 2.410, <jats:italic>P<\/jats:italic> = 0.019), cystatin (Z = \u22124.195, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), incidence of hypocalcaemia (<jats:italic>P<\/jats:italic> = 0.036), and absolute number of lymphocytes (Z = \u22123.426, <jats:italic>P<\/jats:italic> = 0.001). Delivery outcomes were also improved in the insulin treatment group compared with the control group, including lower neonatal weight (Z = \u22122.200, <jats:italic>P<\/jats:italic> = 0.028), incidence of macrosomia (\u03c7<jats:sup>2<\/jats:sup> = 4.092, <jats:italic>P<\/jats:italic> = 0.043), gestational age (Z = \u22123.427, <jats:italic>P<\/jats:italic> = 0.001), and rate of intensive care unit (ICU) conversion (<jats:italic>P<\/jats:italic> = 0.014). In conclusion, insulin therapy for HTG in the third trimester of pregnancy could increase the pregnancy weight gain compliance rate, decrease blood lipid levels and the incidence of severe complications such as HTG acute pancreatitis (HTG-AP), and improve pregnancy outcomes.<\/jats:p>","DOI":"10.3389\/fmed.2022.977620","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:28:45Z","timestamp":1667370525000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of insulin in treating severe hypertriglyceridaemia in the third trimester of pregnancy"],"prefix":"10.3389","volume":"9","author":[{"given":"Dong","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoqiang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.13406\/j.cnki.cyxb.001870","article-title":"Progress in clinical treatment of severe gestational hypertriglyceridemia","volume":"43","author":"Song","year":"2018","journal-title":"J Chongqing Med Univer."},{"key":"B2","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/00325481.2020.1752010","article-title":"Predicting fetal loss in severe acute pancreatitis during pregnancy: a 5-year single-tertiary-center retrospective analysis","volume":"132","author":"Yang","year":"2020","journal-title":"Postgrad Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1097\/AOG.0b013e31820755b5","article-title":"Hyperlipidemia-associated pancreatitis in pregnancy managed with fenofibrate","volume":"117","author":"Whitten","year":"2011","journal-title":"Obstet Gynecol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12944-019-1180-7","article-title":"Hypertriglyceridemia triggered acute pancreatitis in pregnancy\u2013diagnostic approach, management and follow-up care","volume":"19","author":"Cruciat","year":"2020","journal-title":"Lipids Health Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"3781","DOI":"10.12114\/j.issn.1007-9572.2021.02.028","volume":"24","year":"2021","journal-title":"Chin General Pract."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2589","DOI":"10.1210\/jc.2012-1250","article-title":"Severe hypertriglyceridemia in pregnancy","volume":"97","author":"Goldberg","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"key":"B7","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1530\/EDM-21-0017","volume":"2021","year":"2021","journal-title":"Endocrinol Diabetes Metab Case Rep."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1016\/j.clnu.2017.09.028","article-title":"A systematic review of the epidemiology, pathophysiology and current management of hyperlipidaemic pancreatitis","volume":"37","author":"Adiamah","year":"2018","journal-title":"Clin Nutr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.aace.2021.01.006","article-title":"Treatment of severe hypertriglyceridemia during pregnancy with high doses of omega-3 fatty acid and plasmapheresis","volume":"7","author":"Nguyen","year":"2021","journal-title":"AACE Clin Case Rep."},{"journal-title":"Williams Obstetrics. 25th Edition","year":"2020","author":"Cunningham","key":"B10"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e227321","DOI":"10.1136\/bcr-2018-227321","article-title":"Familial hypertriglyceridaemia and type 2 diabetes in pregnancy: prevention of acute pancreatitis with diet control and omega-3 fatty acids","volume":"12","author":"Ong","year":"2019","journal-title":"BMJ Case Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s00592-020-01644-z","article-title":"Association between maternal triglycerides and disturbed glucose metabolism in pregnancy","volume":"58","author":"Eppel","year":"2021","journal-title":"Acta Diabetol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.ccl.2015.02.003","article-title":"Women's health considerations for lipid management","volume":"33","author":"Wild","year":"2015","journal-title":"Cardiol Clin."},{"key":"B14","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1159\/000506506","article-title":"Relapsing and progressive complications of severe hypertriglyceridemia: effective long-term treatment with double filtration plasmapheresis","volume":"49","author":"Grupp","year":"2020","journal-title":"Blood Purif."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.11569\/wcjd.v28.i24.1223","article-title":"Progress in diagnosis and treatment of hypertriglyceridemic acute pancreatitis","volume":"28","author":"Yun","year":"2020","journal-title":"Shijie Huaren Xiaohua Zazhi."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.977620\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:28:50Z","timestamp":1667370530000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.977620\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,2]]},"references-count":15,"alternative-id":["10.3389\/fmed.2022.977620"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.977620","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2022,11,2]]},"article-number":"977620"}}