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J Clin Endocrinol Metab. 2013 Feb;98(2):643-52. doi: 10.1210/jc.2012-3481. Epub 2013 Jan 21.

Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinemia in the third trimester.

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1
Metabolic Research Centre, School of Health Sciences, University of Wollongong, Wollongong, New South Wales 2500, Australia.

Abstract

CONTEXT:

Maternal obesity is associated with high plasma triglyceride, poor vascular function, and an increased risk for pregnancy complications. In normal-weight pregnant women, higher triglyceride is associated with increased small, dense low-density lipoprotein (LDL).

HYPOTHESIS:

In obese pregnancy, increased plasma triglyceride concentrations result in triglyceride enrichment of very low-density lipoprotein-1 particles and formation of small dense LDL via lipoprotein lipase.

DESIGN:

Women (n = 55) of body mass index of 18-46 kg/m(2) were sampled longitudinally at 12, 26, and 35 weeks' gestation and 4 months postnatally.

SETTING:

Women were recruited at hospital antenatal appointments, and study visits were in a clinical research suite.

OUTCOME MEASURES:

Plasma concentrations of lipids, triglyceride-rich lipoproteins, lipoprotein lipase mass, estradiol, steroid hormone binding globulin, insulin, glucose, leptin, and adiponectin were determined.

RESULTS:

Obese women commenced pregnancy with higher plasma triglyceride, reached the same maximum, and then returned to higher postnatal levels than normal-weight women. Estradiol response to pregnancy (trimester 1-3 incremental area under the curve) was positively associated with plasma triglyceride response (r(2) adjusted 25%, P < .001). In the third trimester, the proportion of small, dense LDL was 2-fold higher in obese women than normal-weight women [mean (SD) 40.7 (18.8) vs 21.9 (10.9)%, P = .014], and 35% of obese, 14% of overweight, and none of the normal-weight women displayed an atherogenic LDL subfraction phenotype. The small, dense LDL mass response to pregnancy was inversely associated with adiponectin response (17%, P = .013).

CONCLUSIONS:

Maternal obesity is associated with an atherogenic LDL subfraction phenotype and may provide a mechanistic link to poor vascular function and adverse pregnancy outcome.

PMID:
23337718
PMCID:
PMC3736085
DOI:
10.1210/jc.2012-3481
[Indexed for MEDLINE]
Free PMC Article
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