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Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia

Abstract

It is rare for a study to address immediate metabolic change in pre-eclamptic pregnancy. Our aim is to study the ante-partum and post-partum metabolic markers in pre-eclampsia. A total of 33 pre-eclamptic and 200 uncomplicated women with singleton pregnancies were recruited for the prospective research. Immediately ante-partum and 24–48 h postpartum venous blood samples were collected for the analysis of metabolic markers. In the pre-eclamptic group, the ante-partum fasting glucose, fasting insulin, triglyceride and free fatty acid levels were found to be higher than in the control group; however, ante-partum high-density lipoprotein level was lower. Interestingly, fasting glucose and insulin levels decreased by 24–48 h post-partum in both groups and no significant differences were found. Pre-eclamptic patients had lower post-partum high-density lipoprotein (P=0.02), higher triglyceride (P<0.001), higher free fatty acid (P=0.02) and higher apolipoprotein B levels (P=0.01) than the control group. Dyslipidemia lasts from ante-partum to immediate post-partum in pre-eclamptic women in the form of increased triglyceride, higher free fatty acid and decreased high-density lipoprotein levels. We speculate that women with dyslipidemia and higher baseline blood pressure tend to develop pre-eclampsia during pregnancy. Hence, the development of pre-eclampsia may be a ‘marker’ of possible future cardiovascular or metabolic disease.

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References

  1. Bonney EA . Preeclampsia: a view through the danger model. J Reprod Immunol 2007; 76: 68–74.

    Article  CAS  Google Scholar 

  2. ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33. Int J Gynecol Obstet 2002; 77: 67–75.

    Article  Google Scholar 

  3. Buchbinder A, Sibai BM, Caritis S, Macpherson C, Hauth J, Lindheimer MD et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol 2002; 186: 66–71.

    Article  Google Scholar 

  4. Harskamp RE, Zeeman GG . Preeclampsia: at risk for remote cardiovascular disease. Am J Med Sci 2007; 334: 291–295.

    Article  Google Scholar 

  5. Yücesoy G, Ozkan S, Bodur H, Tan T, Cali°kan E, Vural B et al. Maternal and prenatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet 2005; 273: 43–49.

    Article  Google Scholar 

  6. McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ . Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses. Am Heart J 2008; 156: 918–930.

    Article  Google Scholar 

  7. Lykke JA, Langhoff-Roos J, Sibai BM, Funai EF, Triche EW, Paidas MJ . Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother. Hypertension 2009; 53: 944–951.

    Article  CAS  Google Scholar 

  8. Kajantie E, Eriksson JG, Osmond C, Thornburg K, Barker DJ . Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the Helsinki birth cohort study. Stroke 2009; 40: 1176–1180.

    Article  Google Scholar 

  9. Villa PM, Laivuori H, Kajantie E, Kaaja R . Free fatty acid profiles in preeclampsia. Prostaglandins Leukot Essent Fatty Acids 2009; 81: 17–21.

    Article  CAS  Google Scholar 

  10. Soonthornpun K, Soonthornpun S, Wannaro P, Setasuban W, Thamprasit A . Insulin resistance in women with a history of severe pre-eclampsia. J Obstet Gynaecol Res 2009; 35: 55–59.

    Article  CAS  Google Scholar 

  11. Isezuo SA, Ekele BA . Comparison of metabolic syndrome variables among pregnant women with and without eclampsia. J Natl Med Assoc 2008; 100: 1059–1162.

    Article  Google Scholar 

  12. Yen SSE . Endocrine regulation of metabolic homeostasis during pregnancy. Clin Obstet Gynecol 1973; 16: 130–147.

    Article  CAS  Google Scholar 

  13. Bodnar LM, Ness RB, Markovic N, Roberts JM . The risk of preeclampsia rises with increasing prepregnancy body mass index. Ann Epidemiol 2005; 15: 475–482.

    Article  Google Scholar 

  14. Smith GN, Walker MC, Liu A, Wen SW, Swansburg M, Ramshaw H et al. A history of preeclampsia identifies women who have underlying cardiovascular risk factors. Am J Obstet Gynecol 2009; 200: 58. e1–e8.

    Article  Google Scholar 

  15. Hubel CA, McLaughlin MK, Evans RW, Hauth BA, Sims CJ, Roberts JM . Fasting serum triglycerides, free fatty acids, and malondialdehyde are increased in preeclampsia, are positively correlated, and decrease within 48 hours post partum. Am J Obstet Gynecol 1996; 174: 975–982.

    Article  CAS  Google Scholar 

  16. Saarelainen H, Laitinen T, Raitakari OT, Juonala M, Heiskanen N, Lyyra-Laitinen T et al. Pregnancy-related hyperlipidemia and endothelial function in healthy women. Circ J 2006; 70: 768–772.

    Article  CAS  Google Scholar 

  17. Barbieri RL . Endocrine disorders in pregnancy. In: Yen SSC, Jaffe RB, Barbieri RL (eds). Reproductive Endocrinology. WB Saunders Co: Philadelphia, PA, 1999.

    Google Scholar 

  18. Rademacher TW, Gumaa K, Scioscia M . Preeclampsia, insulin signalling and immunological dysfunction: a fetal, maternal or placental disorder. J Reprod Immunol 2007; 76: 78–84.

    Article  CAS  Google Scholar 

  19. Masuyama H, Nakatsukasa H, Takamoto N, Hiramatsu Y . Correlation between soluble endoglin, vascular endothelial growth factor receptor-1, and adipocytokines in preeclampsia. J Clin Endocrinol Metab 2007; 92: 2672–2679.

    Article  CAS  Google Scholar 

  20. Girouard J, Giguère Y, Moutquin JM, Forest JC . Previous hypertensive disease of pregnancy is associated with alterations of markers of insulin resistance. Hypertension 2007; 49: 1056–1062.

    Article  CAS  Google Scholar 

  21. Roberts JM, Gammill H . Insulin resistance in preeclampsia. Hypertension 2006; 47: 341–342.

    Article  CAS  Google Scholar 

  22. Potter JM, Nestel PJ . The hyperlipidemia of pregnancy in normal and complicatedpregnancies. Am J Obstet Gynecol 1979; 33: 165–170.

    Article  Google Scholar 

  23. Herrera E, Lasuncion MA, Gomez-Coronado D, Aranda P, Lopez-Luna P, Maier I . Role of lipoprotein lipase activity on lipoprotein metabolism and the fate of circulating triglycerides in pregnancy. Am J Obstet Gynecol 1988; 158: 1575–1583.

    Article  CAS  Google Scholar 

  24. Laivuori H, Tikkanen MJ, Ylikorkala O . Hyperinsulinemia 17 years after preeclamptic first pregnancy. J Clin Endocrinol Metab 1996; 81: 2908–2911.

    CAS  PubMed  Google Scholar 

  25. Ray JG, Diamond P, Singh G, Bell CM . Brief overview of maternal triglycerides as a risk factor for pre-eclampsia. BJOG 2006; 113: 379–386.

    Article  CAS  Google Scholar 

  26. Villa PM, Laivuori H, Kajantie E, Kaaja R . Free fatty acid profiles in preeclampsia. Prostaglandins Leukot Essent Fatty Acids 2009; 81: 17–21.

    Article  CAS  Google Scholar 

  27. Endresen J, Lorentzen B, Henriksen T . Increased lipolytic activity and high ratio of free fatty acids to albumin in sera from women with preeclampsia leads to triglyceride accumulation in cultured endothelial cells. Am J Obstet Gynecol 1992; 167: 440–447.

    Article  CAS  Google Scholar 

  28. Fasshauer M, Seeger J, Waldeyer T, Schrey S, Ebert T, Kratzsh J et al. Serum levels of the adipokineadipocyte fatty-acid-binding protein are increased in preeclampsia. Am J Hypertens 2008; 21: 582–586.

    Article  CAS  Google Scholar 

  29. Kajantie E, Kaaja R, Ylikorkala O, Andersson S, Laivuori H . Adiponectin concentrations in maternal serum: elevated in preeclampsia but unrelated to insulin sensitivity. J Soc Gynecol Investig 2005; 12: 433–439.

    Article  CAS  Google Scholar 

  30. Sharma A, Satyam A, Sharma JB . Leptin, IL-10 and inflammatory markers (TNF-alpha, IL-6 and IL-8) in pre-eclamptic, normotensive pregnant and healthy non-pregnant women. Am J Reprod Immunol 2007; 58: 21–30.

    Article  CAS  Google Scholar 

  31. Clausen T, Djurovic S, Henriksen T . Dyslipidemia in early second trimester is mainly a feature of women with early onset pre-eclampsia. BJOG 2001; 108: 1081–1087.

    CAS  PubMed  Google Scholar 

  32. Edlow AG, Srinivas SK, Elovitz MA . Investigating the risk of hypertension shortly after pregnancies complicated by preeclampsia. Am J Obstet Gynecol 2009; 200: e60–e62.

    Article  Google Scholar 

  33. Schobel HP, Fischer T, Heuszer K, Geiger H, Schmieder RE . Preeclampsia—a state of sympathetic overactivity. N Engl J Med 1996; 335: 1480–1485.

    Article  CAS  Google Scholar 

  34. Bartha JL, González-Bugatto F, Fernández-Macías R, González-González NL, Comino-Delgado R, Hervías-Vivancos B . Metabolic syndrome in normal and complicated pregnancies. Eur J Obstet Gynecol Reprod Biol 2008; 137: 178–184.

    Article  CAS  Google Scholar 

  35. Ray JG, Vermeulen MJ, Schull MJ, McDonald S, Redelmeier DA . Metabolic syndrome and the risk of placental dysfunction. J Obstet Gynaecol Can 2005; 27: 1095–1101.

    Article  Google Scholar 

  36. Wilson BJ, Watson MS, Prescott GJ, Sunderland S, Campbell DM, Hannaford P et al. Hypertensive diseases in pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ 2003; 326: 845–851.

    Article  Google Scholar 

  37. Thadhani R, Stampfer MJ, Hunter DJ, Manson JE, Solomon CG, Curhan GC . High body mass index and hypertotal cholesterol emia: risk of hypertensive disorders of pregnancy. Obstet Gynecol 1999; 94: 543–550.

    CAS  PubMed  Google Scholar 

  38. Harskamp RE, Zeeman GG . Preeclampsia: at risk for remote cardiovascular disease. Am J Med Sci 2007; 334: 291–295.

    Article  Google Scholar 

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Correspondence to J M Niu.

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Lei, Q., Lv, L., Zhang, B. et al. Ante-partum and post-partum markers of metabolic syndrome in pre-eclampsia. J Hum Hypertens 25, 11–17 (2011). https://doi.org/10.1038/jhh.2010.29

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