Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Effect of normal pregnancy on plasma levels of lipoprotein (a)

Authors
Bemanali Jalali 1
Hasan Mozaffari 2
Mohammad Hossein Parsaeian 1
Mojgan Sharoghzadeh 1
1 Department of Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Department of Nutrition, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract
Introduction: Lipoprotein (a) [Lp(a)], a cholesterol- rich particle in human plasma is an indepe-ndent risk factor for atherosclerosis. In addition to diabetes mellitus and renal failure, normal and complicated pregnancy may affect the plasma levels of this lipoprotein. Since the effect of pregnancy and its complication on plasma level of Lp(a) is race dependent, the aim of present study was to evaluate the effect of pregnancy on plasma Lp(a) level in a group of normal preg-nant women living in Yazd City. Materials and Methods: The study groups included 94 normal pregnant women (with a mean age 24.6 ± 4.33 years) and 51 non-pregnant women (mean age 26.2±6.73 years). Fasting blood samples were collected in the morning and sera were stored at –70 °C until Lp(a) was assayed. Statistical analysis included, U-test and Wilcoxon-test for comparison of Lp(a), t-test for compa-rison of lipids, Kruskal-Wallis-test for comparison of variables in four groups (first, second, third, trimesters and control) and Pearson correlation test, for correlation of Lp(a) to other variables. Results: plasma Lp(a) levels in study group did not correlate significantly with age and other lipids, and in the pregnant group, (Mean±SD, 25±22.5 mg/dl) were significantly (p=0.01) higher than controls (18±13.5 mg/dl). Lp(a) plasma levels did not show any significant correlation with age, cholesterol and triglyceride levels. Plasma Lp(a) levels in the second half of pregnancy (31±22.4 mg/dl) was higher than the levels in the first half (20±16 mg/dl). Comparison of plasma Lp(a) in the third trimester and control showed a significant elevation in the third trimester. Conclusion: The results of the present study indicate that like most other reports, plasma Lp(a) levels increased during normal pregnancy in our study population, and the elevation is more pronounced in the second half of pregnancy. Since very high levels of plasma Lp(a), may affect placental circulation, more studies are needed to clarify the possible role of this lipoprotein in complicated pregnancies such as pre-eclampsia, history of low birth weight and repeated fetal loss.
Keywords
Lipids
Lipoprotein (a)
normal pregnancy
Plasma lipoproteins
risk factor
Berg K. A new serum type system, the Lp syst-em.Acta Pathol Microbiol Scand.1963;59:369-82.
Mbewu A.D., Durrington P.N. Lipoprotein(a): structure and possible involvement in thromboge-nesis and atherogenesis. Atherosclerosis.1990;85: 1-14.
Uterman G. The mysteries of lipoprotein(a). Science.1989;246:904-910.
Lip G.Y.H., Jones A.F. Lipoprotein(a) and vas-cular disease: thrombogenesis and atherogenesis. QJM.1995;88:529-539.
Eric B., Carla C., Lefert G.L., Carolin L., Giul- ia C., et al. Apolipoprotein(a) gene accounts for greater than 90% of the variations in plasma lipoprotein(a) concentrations.J Clin Invest.1992; 90:52-60.
Para H.G., Luyey I., Buramoue C., Demarqu-illy C., Fruchart J.C. Black- White differences in serum lipoprotein(a) levels. Clin Chem Acta. 1987;167:27-31.
Scanu A.M. Lipoprotein(a): a genetic risk fac-tor for premature coronary heart disease. JAMA. 1992;267:3326-3329.
Dahlen G.H., Gayton J.R., Attar M., Farmer J.A., Kautz J.A., et al. Association of levels of lip-oprotein(a), plasma lipids and other lipoproteins with coronary artery disease documented by angi-ography. Circulation.1986;74:758-765.
Labeur C., Bacquer D., Debacker G., Vincke J., Muyldermans L., et al. Plasma lipoprotein(a) val- ues and severity of coronary artery disease in a large population undergoing coronary angiogra-phy. Clin Chem.1992;38:2261-2266.
Kim J.Q., Song J.H. High allele frequency of apolipoprotein(a) phenptype LPs4 is associated with low serum Lp(a) concentrations in Korians. Clin Biochem.1994;27:57-62.
Kim C.J., Ryu W.S., Kawak J.W., Park C.T., Ryoo U.H., et al. Change in lipoprotein(a) and lipid levels after cessation of female sex hormone production and estrogen replacement therapy. Arch Inter Med.1996;156:500-504.
Kim C.J., Min Y.K., Ryu W.S., Kwak J.W., Ryoo U.H., et al. Effect of hormone replacement therapy on lipoprotein(a) and lipid levels in post-menopousal women. Arch Inten Med.1996;156: 1693-1700.
Herrera E., Gomez- Coronado D., Lasuncion M.A. Lipid metabolism in pregnancy. Biol Neon-ate.1987;51:70-77.
Mazurkiewicz J.C., Watts G.F., Warburton F. G., Slavin B.M., Lowy C., et al. Serum lipids, lip-oproteins and apolipoproteins in pregnant nondia-betic patients. J Clin Pathol.1994;47:728-731.
Hubel C.A., Shakir Y., Gallaher M.J., Mclau-ghlin M.D., Roberts J.M., et al. Low density lipo-protein particle size decrease during normal preg-nancy in association with tryglyceride increases. J Soc Gynecol Invest.1998;5:244-250.
Murakami M., Okuyama T., Tokuoka S., Hor- ie M., Saeki H., et al. Change in serum lipopro-tein(a) levels related to hyperlipidemia during pre- gnancy.Nippon Sanka F ujnikai.1996;43:177-183.
Wersch J.W., Mackelenbergh B.A., Vbachs J. M. Lipoprotein(a) in smoking and non-smoking pregnant women. Scand J Clin Lab Invest.1994; 54:361-364.
Zenchner R., Desoye G., Schweditsch M.O., Pfeiffer K.P., Koster G.M. Fluctuation of plasma lipoprotein(a) concentration during pregnancy and post partum. Metabolism.1986;35:333-336.
Zanaboni F., Bianchi G., Vigoni R. Lipoprote-in(a), a new atherosclerotic risk factor. Blood levels in normal pregnancy. Minerva Ginecol. 1992;44:325-328.
Chiang A.N., Yang M.L., Hung J.H., Chou P., Shyn S.K., Ng H.T. Alteration of serum lipid levels and their biological relevances during and after pregnancy. Life Sci.1995;56:2367-75.
Wang J., Mimuro S., Lahoud R., Trudinger R., Wang X.L. Elevated levels of lipoprotein(a) in women with preeclampsia. Am J Gynecol.1998; 178:146-149.
Leerink C.B., de Vries C.V., Van der Klis F.R. Elevated levels of lipoprotein(a) and apolipo-protein(a) phenotype are not related to pre-eclampsia. Acta Obstet Gynecol Scand.1997;76: 625-628.
Koukkou E., Watts G.F., Mazurkiewicez J., Lowy C. Ethnic differences in lipid and lipopro-tein metabolism in pregnant women of african and caucasian origin. J Clin Pathol.1994;47:1105-1107.
Winfried M., Werner G. Quntification of hu-man serum lipoprotein(a): zone immunoelectroph-oresis assay, a new sensitive method as compared to electroimmuno assay. Clin Chim Acta.1983; 134:265-279.
Abe A., Maeda S., Makini K., Seishima M., Shimikawa K., et al. Enzymed-linked immunosor-bent assay of lipoprotein(a) in serum and cord blood. Clin Chem.1990;36:20-23.
Brizzi P., Tonolo G., Esposito F., Puddu L., Dessole S., et al. Lipoprotein metabolism during normal pregnancy. J Obstet Gynecol.1999;181: 430-434.
Zhao Y., Tang H., Liu S. Serum lipoprotein(a) in women with pregnancy induced hypertension. Zhonghua Fu Chan Ke Za Zhi.2000;35:145-147.
Sattar N., Greer I.A., Louden J., Lindsay G., McConnell M., et al. Lipoprotein subfraction cha-nges in normal pregnancy.J Clin Endocrinol Me- tab.1997;82: 2483-2491.
Arcos F., Castelo C., Casals E., Sanllehy C., Cararach V. Normal and gestational diabetic preg-nancies lipids, lipoproteins and apolipoproteins. J Reprod Med. 1998;43:144-148.
Martin V., Davies C., Hayuvi S., Hartland A,. Dunne F. Is normal pregnancy atherogenic? Clin Sci Colch. 1999;96:421-425.
Kaminski K., Czuba B., Fiegler P. Predictive usefulness of lipoprotein(a)- Lp(a) in cases of pre-eclampsia. Ginekol Pol.2000;71:777-782.
Bar J., Harell D., Bardin R., Pardo J., Chen R., et al. The elevated plasma lipoprotein(a) conc-entrations in preeclampsia do not precede the dev-elopment of the disorder. Thrombo Res.2002;105: 19-23.
Uslu A., Uslu T., Bingol F., Aydin S. Lipop-rotein levels in patients with pregnancy induced hypertension. Arch Gynecol Obstet.1996;258:21-24.
Rymer J., Constable S., Lumb P., Crook M. Serum lipoprotein (A) and apolipoproteins during pregnancy and postpartum in normal women. J Obstet Gynaecol.2002;22:256-259.
Mantent G.T., Franx A., Van der Hoek Y.Y., Hameeteman T.M., Voorbij H.A., et al. Changes of plasma lipoprotein(a) during and after pregnan-cy in Caucasians. Matern Fetal Neonatal Med. 2003;14:91-95.
Sattar N., Clark P., Greer I.A., Shepherd J., Packard C.J. Lipoprotein(a) levels in normal preg-nancy and in pregnancy complicated with pre-eclampsia. Atherosclerosis.2000;148:407-411.
Ricci G., Tamaro G., Simeone R., Giolo E., Nucera G., et al. Lipoprotein(a) changes during natural menstrual cycle and ovarian stimulation with recombinant and highly purified urinary FSH. Hum Reprod. 2001;16:449-456.
Soma M.R., Meschia M., Bruschi F., Morrise-tt J.D., Paoletti R., et al. Hormonal agents used in lowering lipoprotein(a). Chem Phys Lipids.1994; 67-68:345-350.
Berg K., Roald B., Sande H. High lipopro-tein(a) levels in maternal may interfere with plac-ental circulation and cause fetal growth retarda-tion. Clin Genet.1994;46:52-56.
Mori M., Mori A., Saburi Y., Sida M., Ohta H. Levels of lipoprotein(a) in normal and compl-icated pregnancy. J Perinat Med.2003;31: 23-28.
Journal of Reproduction & Infertility
Volume 5, Issue 4
Autumn 2004
Pages 280-289