Implication of apolipoprotein E and the L-arginine-nitric oxide system in preeclampsia

Objective: During pregnancy, Apolipoprotein (Apo) E is synthesized in the p lacenta to facilitate the uptake of maternal lipoproteins. Preeclampsia is associated with an abnormal lipid profile. Apo E levels may affect the prod uction of nitric oxide. We investigated whether Apo E variations could be r elated to the high lipid levels and nitric oxide secretion in preeclamptic women. Methods: Blood samples from 15 normotensive women and 12 mild and 23 severe cases of preeclampsia were assayed for standard lipid profile, Apo E, and nitrate. Urine samples were analyzed for nitrate and cyclic GMP. Results: In women with mild preeclampsia, the triglyceride concentration wa s significantly higher (p < 0.05) than in normotensive women (3.30 +/- 1.38 versus 2.31 +/- 0.92 g/L) and associated with a higher (p < 0.01) triglyce ride/Apo E ratio (0.71; range = 0.40-1.70). In women with severe preeclamps ia, the triglyceride/Apo E ratio was similar to normotensive women [0.39 (r ange = 0.18-1.19) versus 0.41 (range = 0.18-0.79)] associated with a normal triglyceride level and a twofold higher serum nitrate level [36 (range = 1 -63 mu mol/L) versus 14 (range = 1-37 mu mol/L)]. Conclusion: The triglyceride/Apo E ratio is significantly higher in mild pr eeclampsia. In the severe form, this ratio is similar to that of normotensi ve pregnant women, probably due to a better uptake of triglyceride, Moreove r, in the severe form, it is associated with a twofold normal serum nitrate level. Thus, Apo E and the nitric oxide status may be implicated in preecl ampsia.