FASTING SERUM TRIGLYCERIDES, FREE FATTY-ACIDS, AND MALONDIALDEHYDE ARE INCREASED IN PREECLAMPSIA, ARE POSITIVELY CORRELATED, AND DECREASE WITHIN 48 HOURS POST-PARTUM

OBJECTIVE: We tested the hypothesis that serum free (nonesterified) fa tty acid and triglyceride concentrations are increased in nulliparous women with preeclampsia relative to women with uncomplicated pregnanci es and that these lipids decrease post partum, consistent with the kno wn resolution of clinical symptoms. The relationships between serum co ncentrations of these lipids and the lipid peroxidation metabolite mal ondialdehyde were also examined. STUDY DESIGN: Predelivery and 24 to 4 8 hour postpartum venous blood samples were collected from eight women with preeclampsia and nine women with uncomplicated pregnancies after an 8- to 10-hour fast. Sera were analyzed for concentrations of trigl ycerides, free fatty acids, total cholesterol, high-density lipoprotei n cholesterol, low-density lipoprotein cholesterol, and malondialdehyd e. RESULTS: Antepartum serum triglyceride and free fatty acid concentr ations were increased approximately twofold in women with preeclampsia relative to uncomplicated pregnancies (p < 0.02 and 0.004, respective ly). Total, high-density lipoprotein, and low-density lipoprotein chol esterol concentrations did not differ between groups. Concentrations o f all lipids decreased significantly in both groups within 48 hours po st partum. However, triglyceride and free fatty acid concentrations re mained higher in women with preeclampsia (p < 0.006, both variables). Triglyceride and free fatty acid concentrations correlated positively, both ante partum (R(2) 0.42, p < 0.01) and post partum (R(2) 0.39, p < 0.02). Antepartum concentrations of malondialdehyde were 50% higher in women with preeclampsia (p < 0.01) and decreased post partum (p < 0 .02) but did not decrease in controls (p = 0.07). Antepartum serum tri glycerides and free fatty acids correlated positively with malondialde hyde concentrations (R(2) 0.38, p < 0.02, in both cases). CONCLUSION: Triglycerides and free fatty acids, but not cholesterol, are increased in preeclampsia and correlate with the lipid peroxidation metabolite malondialdehyde. We speculate that these interactions may contribute t o endothelial cell dysfunction in preeclampsia.