Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country

Abstract

Background: An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country. Methods: A multi-center case–control study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis. Results: Women with PE had lower concentrations of PIGF (p < 0.0001) and higher concentrations of s-Eng (p = 0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p = 0.0004) and lower PIGF concentrations (p < 0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p = 0.005). Women with severe PE had higher concentrations of s-Eng (p = 0.0008) and ox-LDL (p = 0.01), and lower concentrations of PIGF (p < 0.0001). Conclusions: Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies.

Keywords::

• Preeclampsia
• angiogenesis
• lipid alterations
• pathophysiology

Acknowledgements

The authors would like to acknowledge COLCIENCIAS (Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología «Francisco José de Caldas») for the financial support to the VILANO Group (Grant No. 6566-04-18061). Furthermore, the authors acknowledge the following institutions for their support: Clínica Materno Infantil San Luis, Bucaramanga, Colombia; Hospital Niño Jesús, Barranquilla, Colombia; Clínica de la Costa, Barranquilla, Colombia; Instituto del Corazón de Santa Marta, Santa Marta, Colombia; ESE Hospital Universitario Erasmo Meoz, Cúcuta, Colombia; ESE Hospital Manuel Uribe Ángel, Envigado, Colombia; ESE Hospital San Juan de Dios, Floridablanca, Colombia.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.