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Low Density Lipoprotein (LDL) Subfractions during Pregnancy: Accumulation of Buoyant LDL with Advancing Gestation

Departments of Clinical Chemistry (K.W., M.M.H., I.F., H.W., W.M.), Obstetrics and Gynecology (B.W., M.K., H.P.Z.), and Sports Medicine (M.W.B.), University of Freiburg, D-79106 Freiburg, Germany

Address all correspondence and requests for reprints to: Karl Winkler, M.D., Department of Clinical Chemistry, Albert Ludwigs University School of Medicine, Hugstetter Strasse 55, D-79106 Freiburg, Germany. E-mail: kwinkler{at}ukl.uni-freiburg.de

Pregnancy is accompanied by changes in the maternal lipoprotein metabolism that may serve to satisfy the nutritional demands of the fetus. In this study lipoprotein metabolism was investigated in 23 women during normal pregnancy in the first, second, and third trimesters and in 15 healthy nonpregnant women with regular menstrual cycles. Lipid and apolipoprotein concentrations were measured in total plasma, very low density, intermediate density, low density (LDL), and high density lipoproteins, and in each of six LDL subfractions. During early pregnancy, triglycerides, and dense LDL were higher than in the nonpregnant state. With advancing gestation, triglycerides increased and the distribution of apolipoprotein B-100-containing lipoproteins became increasingly dominated by the accumulation of very low density and intermediate density lipoproteins and buoyant, triglyceride-rich LDL. This is the first study that investigates LDL subfractions in pregnancy using a method that strictly separates LDL subfractions by virtue of density. The accumulation of buoyant, triglyceride-rich lipoproteins may be related to the down-regulation of maternal lipase activities by placental hormones. As a consequence, the metabolic changes of late pregnancy may result in an increased flux of lipoprotein-derived lipids to the placenta, which, with advancing gestation, increasingly expresses receptors with a high affinity for triglyceride-rich lipoproteins.

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