LIPOPROTEIN SUBFRACTION CONCENTRATIONS IN PREECLAMPSIA - PATHOGENIC PARALLELS TO ATHEROSCLEROSIS

Objective: To determine whether large triglyceride-rich lipoproteins, very-low-density lipoprotein(1) (VLDL(1)), and small, dense low-densit y lipoprotein (LDL-III), are significantly increased in women with pre eclampsia compared with concentrations seen in normal pregnancy. Metho ds: Plasma concentrations of very-low-density and low-density lipoprot ein subfractions and pre-heparin hepatic lipase activity were measured in eight women with preeclampsia and in eight healthy pregnant contro ls matched for age, gestational age, and weight. Results: Women with p reeclampsia exhibited higher median plasma triglyceride concentrations (3.68 versus 1.93 mmol/L, P = .004) compared with controls. This was reflected in an almost threefold increase in median VLDL(1) (184 versu s 68 mg/dL, P = .002) and a twofold increase in very-low-density lipop rotein(2) (VLDL(2)) (146 versus 76 mg/dL, P = .014), whereas total pla sma cholesterol, intermediate-density lipoprotein, and total LDL conce ntrations were the same in subjects and controls. Furthermore, women w ith preeclampsia demonstrated significantly lower concentrations of th e large, buoyant LDL subfractions, LDL-I and LDL-II, and markedly elev ated median plasma concentrations of small, dense LDL, LDL-III(ISO ver sus 55 mg/dL, P = .024). High-density lipoprotein-cholesterol concentr ation also was significantly lower (P = .021), and pre-heparin hepatic lipase activity was significantly elevated (29 versus 18 mu mol fatty acids/ml/hour, P = .041) in the preeclamptic group. The concentration of small, dense LDL correlated positively with plasma triglyceride co ncentration (r(2) = 0.504, P = .002). Conclusions: Women with preeclam psia exhibit markedly elevated concentrations of triglyceride-rich lip oproteins in the circulation. These particles are potential contributo rs to endothelial dysfunction and the expression of preeclampsia, both directly and, indirectly, through the generation of small, dense LDL. Copyright (C) 1997 by The American College of Obstetricians and Gynec ologists.