Lipid abnormalities in pre-eclampsia:implications for vascular health

Abstract

Pre-eclampsia is a hypertensive disorder associated with proteinuria appearing during the second half of pregnancy. It is also a state of increased insulin resistance and sympathetic overactivity. The most common lipid abnormalities are hypertriglyceridemia and increased circulating free fatty acids, which can precede the onset of the disease. The other abnormalities include low HDL-C (especially HDL-2-C) and a relatively high small density LDL-C level. These lipid/lipoprotein abnormalities may enhance endothelial dysfunction, which is the major pathogenetic factor of pre-eclampsia. These lipid/lipoprotein abnormalities may enhance endothelial dysfunction during pre-eclamptic pregnancy by increased free fatty acids and oxidative stress, bythe blunting of nitric oxide-dependent tone and by impairing the prostacyclin:thromboxane ratio. These abnormalities resolve after delivery, but may ‘return’ if the woman becomes insulin resistant de novo with weight gain and/or loses ovarian estrogen production.

Keywords:

• dyslipidemia
• endothelial dysfunction
• free fatty acid
• HDL-C
• insulin resistance
• LDL-C
• lipase
• oxidized lipid
• pre-eclampsia
• triglyceride