Bw. Arbogast et al., PLASMA FACTORS THAT DETERMINE ENDOTHELIAL-CELL LIPID TOXICITY IN-VITRO CORRECTLY IDENTIFY WOMEN WITH PREECLAMPSIA IN EARLY AND LATE PREGNANCY, Hypertension in pregnancy, 15(3), 1996, pp. 263-279
Objective: We proposed that women who develop preeclampsia have a low
ratio of ''protective'' toxicity preventing activity (TxPA) to ''toxic
'' very low density lipoproteins (VLDL) late in pregnancy. Having conf
irmed this hypothesis, we then tested whether this low ratio would man
ifest itself early in the pregnancy of women who develop preeclampsia.
Methods: Serially collected plasma from women who developed preeclamp
sia and from matched controls was assayed blind for TxPA, triglyceride
s, cholesterol, high-density lipoproteins, albumin, and nonesterified
fatty acids (NEFA). Main Outcome Measures: Plasma concentrations of li
pids, NEFA, and proteins which bind NEFA (TxPA and albumin) were measu
red in normal and preeclamptic women. These parameters were formulated
prior to data collection because of the low albumin/triglyceride rati
os and the elevated NEFA levels reported to occur in preeclampsia. Res
ults: In late pregnancy, TxPA was lower (1.82 +/- 0.63 vs. 2.30 +/- 0.
40 g/dL, P = 0.008) and VLDL higher (292 +/- 130 vs. 206 +/- 60 mg/dL,
P = 0.013) in preeclamptics than in controls. Discrimination analysis
(TxPA and triglyceride), correctly classified 95% of the preeclamptic
s and 79% of the controls in late pregnancy. The ratio of TxPA to non-
TxPA and triglyceride correctly classified 92% of the preeclamptics an
d 85% of the controls in early pregnancy. Conclusions: The ratio of Tx
PA to VLDL accurately distinguishes preeclamptic from normal pregnant
women, suggesting that both these factors are involved in the developm
ent of preeclampsia.