Serum Levels of Apolipoprotein A-I, A-II and HDL-Cholesterol in Second Half of Normal Pregnancy and in Pregnancy Complicated by Pre-Eclampsia

Abstract

Serum concentrations of Apolipoprotein A-I and A-II, (Apo A-1 and Apo A-II) HDL-cholesterol (HDL-C), Total Cholesterol (TC), triglycerides (TG) and lipoprotein electrophoresis were assayed serially in the second half of normal pregnancy (21 women), in pre-eclampsia (26 women) and in both groups one and six weeks after delivery. In the normal group we found increased concentrations of Apo A-I and HDL-C, which remained unaltered during pregnancy. Apo A-II was unchanged. Correlation coefficients for Apo A-II vs HDL-C and Apo A-I vs Apo A-II decreased gradually towards delivery while it remained at an elevated and unaltered level for Apo A-I vs HDL-C. The Apo A-I/HDL-C ratio was unaltered during the whole study while the Apo A-I/A-II ratio was elevated during pregnancy and the Apo A-II/HDL-C ratio was reduced. These results may indicate a gradual change in the surface structure of the HDL particle or its subfractions. In pre-eclampsia Apo A-I and HDL-C concentrations were reduced, TG was increased and Apo A-II and TC were unchanged when compared with the normal pregnancy group. A more pronounced correlation coefficient was recorded for Apo A-I vs HDL-C than for Apo A-II vs HDL-C and Apo A-I vs Apo II. The results indicate that from an atherogenic point of view normal pregnancy seems more beneficial than pre-eclampsia.

A controlled study of maternal serum concentrations of lipoproteins in pregnancy-induced hypertension

“…Serum triglyceride (TG) and cholesterol (CHOL) levels increase steadily as pregnancy progresses. These changes are thought to be mediated by gestational hormones [4,13,15].…”

“…9], but others reported a more pronounced hypertriglyceridaemia in pregnancy complicated by hypertension compared to normal pregnancy [8,12,16,17]. When all these studies are reviewed, there appears to be some evidence that PIH and related disorders may be associated with a typical serum lipoprotein pattern that is characterized by elevation of the concentration of certain TG-rich lipoproteins (TRL), namely verylow-density lipoproteins (VLDL) [8,12,13,15,17], and lower high-density lipoprotein (HDL) levels [11,13,17] compared to the situation in normal pregnancy. The heterogeneity of the published data is not surprising, considering the different study designs and methods of lipid analysis utilized.…”

Learning From the Placenta

“…19 Preeclampsia and cardiovascular disease share many risk factors, including endothelial dysfunction, obesity, hyperglycemia, insulin resistance, diabetes mellitus, hypertension, and dyslipidemia (including hypertriglyceridemia and small, dense low-density lipoprotein [LDL] particles). [21][22][23][24][25] Summarized, the normal development of maternal hyperlipidemia of pregnancy is exaggerated in preeclampsia. In normal pregnancy, there is during late gestation a 3-fold increase in circulating triglycerides and a 50% increase in total cholesterol, 26 presenting mostly as LDLs, as well as a small increase in phospholipids.…”

Pregnancy and Long-Term Maternal Cardiovascular Health

“…Both preeclampsia 57 and atherosclerosis 58,59 arise from vascular inflammation with its associated endothelial dysfunction. Common risks include obesity, diabetes mellitus, insulin resistance and hyperglycemia, dyslipidemia (including hypertriglyceridemia and small, dense low-density lipoprotein particles), [60][61][62][63][64] hypertension, a family history of CVD, 65 and the metabolic syndrome.…”