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Triglyceride-Rich Lipoproteins Are Associated with Hypertension in Preeclampsia

Departments of Clinical Chemistry (K.W., M.M.H., I.F., H.W.), Obstetrics and Gynecology (B.W., M.K., H.-P.Z.), and Sports Medicine (M.W.B.), University of Freiburg, Germany; and Clinical Institute of Medical and Chemical Laboratory Diagnostics (W.M.), University of Graz, Graz, Austria

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

Disorders of the lipoprotein metabolism are a major cause of endothelial dysfunction that may result in hypertension and proteinuria, clinical hallmarks of preeclampsia (PE). Lipoproteins and low-density lipoprotein (LDL) subfractions were investigated in 15 women with severe PE and compared with 23 women with a normal course of pregnancy. Compared with normal pregnancy, in PE apolipoprotein (apo)B in very low-density lipoprotein was increased by 76% (P = 0.008), and the triglyceride content of intermediate dense lipoproteins (IDL) was increased by 51% (P < 0.001); cholesterol and apoB in LDL were decreased by 26% (P = 0.005) and 23% (P = 0.016), respectively. Although not significant, the LDL profile was dominated by the most buoyant LDL-1. ApoB in the most dense LDL (dLDL), namely LDL-5 and LDL-6, was significantly decreased by 49% (P < 0.001) and 55% (P < 0.001), respectively. Diastolic blood pressure was positively correlated with the triglyceride content of IDL (r = 6.31; P < 0.001 and r = 0.352; P = 0.033 by partial correlation controlling for the presence or absence of PE) and negatively correlated with the concentration of apoB in dLDL (r = -0.500; P = 0.002). In addition, IDL triglycerides correlated negatively with infant birth weight percentile (r = -0.373; P = 0.027) and positively with proteinuria (r = 0.430; P = 0.014). Low birth weight was associated with high IDL triglycerides and low rather than high concentrations of dLDL. Triglyceride-rich remnants are known to cause endothelial dysfunction. Because the triglyceride content of IDL was positively correlated with elevated blood pressure and proteinuria, triglyceride-rich remnant lipoproteins might contribute to the pathophysiology of PE.

Abbreviations: apo, Apolipoprotein; CH, cholesterol; CS, cesarean section; dLDL, dense low-density lipoprotein; HDL, high-density lipoprotein; HL, hepatic lipase; IDL, intermediate dense lipoprotein; LDL, low-density lipoprotein; LPL, lipoprotein lipase; PE, preeclampsia; TG, triglyceride; VLDL, very low-density lipoprotein.

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