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Highly Atherogenic Lipid Particles are Associated with Preeclampsia After Successful Fertility Treatment for Obese Women who have Unexplained Infertility

  • Maternal Fetal Medicine/Biology: Original Article
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Abstract

Atherogenic dyslipidemia—before or during pregnancy—may contribute to preeclampsia and subsequent cardiovascular disease risk. We performed a nested case-control study to further understand dyslipidemia associated with preeclampsia. The cohort consisted of participants in the randomized clinical trial “Improving Reproductive Fitness Through Pretreatment with Lifestyle Modification in Obese Women with Unexplained Infertility” (FIT-PLESE). FIT-PLESE was designed to study the effect of a pre-fertility treatment 16-week randomized lifestyle intervention program (Nutrisystem diet + exercise + orlistat vs. training alone) on improvement in live birth rate among obese women with unexplained infertility. Of the 279 patients in FIT-PLESE, 80 delivered a viable infant. Maternal serum was analyzed across five visits: before and after lifestyle interventions and also at three pregnancy visits (16, 24, and 32 weeks gestation). Apolipoprotein lipids were measured in a blinded fashion using ion mobility. Cases were those who developed preeclampsia. Controls also had a live birth but did not develop preeclampsia. Generalized linear and mixed models with repeated measures were used to compare the mean lipoprotein lipid levels of the two groups across all visits. Complete data were available for 75 pregnancies, and preeclampsia developed in 14.5% of the pregnancies. Cholesterol/high-density lipoprotein (HDL) ratios (p < 0.003), triglycerides (p = 0.012), and triglyceride/HDL ratios, all adjusted for BMI, were worse in patients with preeclampsia (p < 0.001). Subclasses a, b, and c of highly atherogenic, very small, low-density lipoprotein (LDL) particles were higher during pregnancy for the preeclamptic women (p < 0.05). Very small LDL particle subclass d levels were significantly greater only at 24 weeks (p = 0.012). The role of highly atherogenic, very small LDL particle excess in the pathophysiology of preeclampsia awaits further investigation.

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Funding

This study work was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grants U10HD077680 Reproductive Medicine Network (RMN) and 1 R03 HD101893-01 and a contract for blind analysis of the lipoprotein lipids from Quest Diagnostics. Presented in part at the Society for Reproductive Investigation (SRI) 68th Annual Meeting in Boston, Massachusetts: Abstract O-010 Reproductive Sciences Vol 28, Supplement 1, July 2021.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    R. A. Wild, R. K. Edwards, K. R. Hansen & A. S. Kim

  2. Biostatistics and Clinical Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    R. A. Wild & D. Zhao

  3. Quest Diagnostics, Secaucus, NJ, USA

    D. S. Wrenn

Authors
  1. R. A. Wild
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  2. R. K. Edwards
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  3. D. Zhao
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  4. K. R. Hansen
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  5. A. S. Kim
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  6. D. S. Wrenn
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Correspondence to R. A. Wild.

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None related to this manuscript. Dr. Wren was the Clinical Director of Quest laboratories at the time of the lipoprotein analysis.

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Wild, R.A., Edwards, R.K., Zhao, D. et al. Highly Atherogenic Lipid Particles are Associated with Preeclampsia After Successful Fertility Treatment for Obese Women who have Unexplained Infertility. Reprod. Sci. 30, 2495–2502 (2023). https://doi.org/10.1007/s43032-023-01197-w

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  • DOI: https://doi.org/10.1007/s43032-023-01197-w

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