Plasma Lipoproteins and Preeclampsia in Women with Type 1 Diabetes: A Prospective Study

Arpita Basu, Petar Alaupovic, Mingyuan Wu, Alicia J Jenkins, Yongxin Yu, Alison J Nankervis, Kristian F Hanssen, Hanne Scholz, Tore Henriksen, Bjørg Lorentzen, Torun Clausen, Satish K Garg, M Kathryn Menard, Samar M Hammad, James A Scardo, John R Stanley, Azar Dashti, Christopher E Aston, Timothy J Lyons

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Context: In nondiabetic pregnancy, cross-sectional studies have shown associations between maternal dyslipidemia and preeclampsia (PE). In type 1 diabetes mellitus (T1DM), the prevalence of PE is increased 4-fold, but prospective associations with plasma lipoproteins are unknown.

Objectives: The aim of this study was to define lipoprotein-related markers and potential mechanisms for PE in T1DM.

Design and Settings: We conducted a multicenter prospective study in T1DM pregnancy.

Patients: We studied 118 T1DM women (26 developed PE, 92 remained normotensive). Subjects were studied at three visits before PE onset [12.2 1.9, 21.6 1.5, and 31.5 1.7 wk gestation (means SD)] and at term (37.6 2.0 wk). Nondiabetic normotensive pregnant women (n 21) were included for reference.

Main Outcome Measures: Conventional lipid profiles, lipoprotein subclasses [defined by size (nuclear magnetic resonance) and by apolipoprotein content], serum apolipoproteins (ApoAI, ApoB, and ApoCIII), and lipolysis (ApoCIII ratio) were measured in T1DM women with and without subsequent PE.

Results: In women with vs. without subsequent PE, at the first and/or second study visits: lowdensity lipoprotein (LDL)-cholesterol, particle concentrations of total LDL and large (but not small) LDL, serum ApoB, and ApoB:ApoAI ratio were all increased (P 0.05); peripheral lipoprotein lipolysis was decreased (P0.01). These early differences remained significant in covariate analysis (glycated hemoglobin, actual prandial status, gravidity, body mass index, and diabetes duration) but were not present at the third study visit. High-density lipoprotein and very low-density lipoprotein subclasses did not differ between groups before PE onset.

Conclusions: Early in pregnancy, increased cholesterol-rich lipoproteins and an index suggesting decreased peripheral lipolysis were associated with subsequent PE in T1DM women. Background maternal lipoprotein characteristics, perhaps masked by effects of late pregnancy, may influence PE risk.
Original languageEnglish
Pages (from-to)1752-62
Number of pages11
JournalThe Journal of clinical endocrinology and metabolism
Volume97
Issue number5
DOIs
Publication statusPublished - 01 May 2012

Keywords

  • Adult
  • Cholesterol
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1
  • Female
  • Hemoglobin A, Glycosylated
  • Humans
  • Lipoproteins
  • Pre-Eclampsia
  • Pregnancy
  • Pregnancy in Diabetics
  • Prospective Studies

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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  • Cite this

    Basu, A., Alaupovic, P., Wu, M., Jenkins, A. J., Yu, Y., Nankervis, A. J., Hanssen, K. F., Scholz, H., Henriksen, T., Lorentzen, B., Clausen, T., Garg, S. K., Menard, M. K., Hammad, S. M., Scardo, J. A., Stanley, J. R., Dashti, A., Aston, C. E., & Lyons, T. J. (2012). Plasma Lipoproteins and Preeclampsia in Women with Type 1 Diabetes: A Prospective Study. The Journal of clinical endocrinology and metabolism, 97(5), 1752-62. https://doi.org/10.1210/jc.2011-3255