Adipocytokines and endothelial function in preeclamptic women

Abstract

Visceral fat accumulation stimulates the production of adipocytokines in patients with metabolic syndrome. Excess body weight gain during pregnancy is a risk factor for preeclampsia. To evaluate whether the pathogenesis of preeclampsia is similar to that of metabolic syndrome, we measured plasma adipocytokine concentrations and investigated the association between plasma adiponectin concentrations and body weight gain or endothelial function in preeclamptic women. We investigated 15 preeclamptic and 17 women with uncomplicated pregnancies. Women with preeclampsia had significantly lower plasma concentrations of adiponectin (10.2 ± 2.0 vs. 7.3 ± 2.2 lg ml À1 , Po0.01), but higher concentrations of leptin, plasminogen activator inhibitor-1, interleukin-6, vascular cell adhesion molecule-1, E-selectin and C-reactive protein. Plasma triglyceride levels were significantly higher in preeclamptic patients, but the levels of other lipids did not differ significantly between the two groups. We found that flow-mediated vasodilation was significantly decreased in preeclamptic women compared with controls (10.6 ± 6.4 vs. 3.8 ± 2.0%, Po0.001). Plasma adiponectin concentrations correlated negatively with body mass index (r¼À0.50, Po0.05) and body weight gain during pregnancy (r¼À0.63, Po0.01), and positively with flow-mediated vasodilation (r¼0.50, Po0.05) in preeclamptic women, but not in women with uncomplicated pregnancies. Similar to the patients with metabolic syndrome, we found that dysregulation of adipocytokines, such as low adiponectin levels and high levels of other adipocytokines, and excess body weight gain during pregnancy, may decrease plasma adiponectin concentrations that are associated with endothelial dysfunction in preeclamptic women.

Shared biomarkers between female diastolic heart failure and pre‐eclampsia: a systematic review and meta‐analysis

“…Five studies reported on insulin levels 37, 45, 55, 62, 75. Three met the requirements for a meta‐analysis,37, 55, 75 revealing higher insulin levels in pre‐eclampsia than in controls with mean difference 1.31 μU/mL; 95%CI 0.93–1.70; P  < 0.00001.…”

“…Thirty‐two studies in total reported on C‐reactive protein levels,21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52 of which 17 were applicable for meta‐analysis 21, 22, 23, 29, 30, 31, 32, 33, 34, 37, 38, 39, 41, 42, 47, 49, 50. A significantly higher C‐reactive protein was found in women with pre‐eclampsia than in non‐hypertensive controls ( Figure 2), and this correlation was stronger in severe than in mild pre‐eclampsia ( Figure 3).…”

“…Twenty‐seven studies reported on HDL levels,32, 37, 41, 44, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74 of which 24 studies could be included in a meta‐analysis 32, 37, 41, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72. HDL level was lower in pre‐eclampsia than in controls (mean difference −6.29 mmol/L; 95%CI −9.74−2.85; P  = 0.0003) with the strongest effect in subgroup analysis for severe pre‐eclampsia vs. controls ( Figure 4).…”

“…Six studies reported on plasma glucose levels, 32, 45, 62, 65, 75, 76 of which five were applicable for meta‐analysis with 115 pre‐eclampsia cases vs. 329 controls 32, 62, 65, 75, 76. Overall, a non‐significantly elevated glucose level was seen in pre‐eclampsia vs. controls.…”

Oxidative stress in the fetus of preeclamptic women with fetal growth restriction

“…In addition, flow-mediated vasodilation (FMD) of the brachial artery, a known marker of vascular endothelial function, was decreased in preeclamptic women. 4) There is also a negative correlation between FMD and levels of derivatives of reactive oxygen metabolites (d-ROMs) in all pregnant women. These results support the notion that in preeclamptic women, endothelial damage is associated with oxidative stress, which is caused by increased oxygen free radical production.…”