Lipoprotein(a) Concentrations in Women with a History of Severe Preeclampsia – a Case Control Study

Maria G. van Pampus; Maria M. W. Koopman; Hans Wolf; Harry R. Büller; Martin H. Prins; Abraham van den Ende

doi:10.1055/s-0037-1614621

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 82(01): 10-13
DOI: 10.1055/s-0037-1614621

Rapid Communication

Schattauer GmbH

Lipoprotein(a) Concentrations in Women with a History of Severe Preeclampsia – a Case Control Study

Maria G. van Pampus

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

,

Maria M. W. Koopman

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

,

Hans Wolf

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

,

Harry R. Büller

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

,

Martin H. Prins

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

,

Abraham van den Ende

¹From the Departments of Gynaecology and Obstetrics, the Centre for Haemostasis, Thrombosis, Atherosclerosis and Inflammation Research, and Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands

› Author Affiliations

Abstract

Summary

A high concentration of lipoprotein(a) is associated with athero-sclerotic disease. Atheroma may develop in spiral arteries in both preeclamptic and normal pregnancies, but they are much more common in preeclampsia, particularly in the decidual segments. We hypothesized that a high concentration of lipoprotein(a) is associated with the development of preeclampsia.

We studied 40 women with a history of severe preeclampsia, 35 women with a history of preeclampsia and the (H)ELLP syndrome and 67 controls with a normal obstetric history. Lipoprotein(a) levels were measured at least 10 weeks post partum in the second half of a normal menstrual cycle. None of the women in the study or the control group were pregnant or used oral contraceptives. Lipoprotein(a) levels over the 90th percentile of the lipoprotein(a) distribution of our control group (420 mg/l) were defined as abnormal. There was a statistically significant higher prevalence of abnormal levels of lipoprotein(a) in women with a history of severe preeclampsia (33%) in comparison with women with a history of preeclampsia and (H)ELLP syndrome (9%) and with the control group (10%).

We found that a history of severe preeclampsia and spontaneous abortion was associated with elevated lipoprotein(a) levels as a post-hoc finding. Whether spontaneous abortion and high levels of lipo-protein(a) are related remains to be demonstrated.

Full Text

References

References
1 Roberts JM, Redman CWG. Pre-eclampsia: more than pregnancy-induced hypertension. Lancet 1993; 341: 1447-54.
2 Groot de CJM, Davidge ST, Friedman SA, McLaughlin MK, Roberts JM, Taylor RN. Plasma from preeclamptic women increases human endothelial cell prostacyclin production without changes in cellular enzyme activity or mass. Am J Obstet Gynecol 1995; 172: 977-84.
3 Hubel CA, McLaughlin MK, Evans RW, Hauth BA, Sims CJ, Roberts JM. Fasting serum triglycerides, free fatty acids, and malondialdehyde are increased in preeclampsia, are positively correlated, and decrease within 48 h post partum. Am J Obstet Gynecol 1996; 174: 975-82.
4 Sattar N, Bendomir A, Berry C, Shepherd J, Greer IA, Packard CJ. Lipoprotein Subfraction Concentrations in Preeclampsia: Pathogenic Parallels to Atherosclerosis. Obstetrics and Gynaecology 1997; 89: 403-7.
5 Redman CWG. Immunological aspects of pre-eclampsia. Bailieres Clin Obstet Gynaecol 1992; 6 (03) 601-15.
6 Dekker GA, de Vries JIP, Doelitzsch PM. et al. Underlying disorders associated with severe early-onset preeclampsia. Am J Obstet Gynecol 1995; 173: 1042-8.
7 Endresen JR M. Preeclampsia and endothelial cell function. Acta Obstet Gynecol Scand 1995; 74: 667-9.
8 Scanu AM. Lipoprotein(a) and atherosclerosis. Ann Intern Med 1991; 115: 2
9 Miles LA, Fless GM, Levin EG, Scanu AM, Plow EF. A potential basis for the thrombotic risks associated with lipoprotein(a). Nature 1989; 339: 301-5.
10 Heinrich J, Sandkamp M, Kokott R, Schulte H, Assmann G. Relationship of lipoprotein(a) to variables of coagulation and fibrinolysis in a healthy population. Clin Chem (Winston-Salem, NC) 1991; 37: 1950-4.
11 Ende van den A, Hoek van der YY, Kastelein JJP, Koschinsky ML, Labeur C, Rosseneu M. Lipoprotein(a). In:. Spiegel H. (ed.) Volume 32: Advances in Clinical Chemistry; 1996; 74-135.
12 Mensink RP, Zock PL, Katan MB, Hornstra G. Effect of dietary cis and trans fatty acids on serum lipoprotein(a) levels in humans. J Lipid Res 1992; 33: 1493-1501.
13 Helmhold M, Bigge J, Muche R. et al. Contribution of the apo (a) phenotype to plasma Lp(a) concentration shows considerable ethnic variation. J Lipid Res 1992; 32: 1919-28.
14 Meekins JW, Pijnenborg R, Hanssens M, Van Assche A, Mcfadyen IR. Immunohistochemical Detection of Lipoprotein(a) in the Wall of Placental Bed Spiral Arteries in normal and Severe Preeclamptic Pregnancies. Placenta 1994; 15: 511-24.
15 Berg K, Roald B, Sande H. High Lp(a) lipoprotein level in maternal serum may interfere with placental circulation and cause fetal growth retardation. Clin Genet 1994; 46: 52-6.
16 Husby H, Roald B, Schjetlein R, Nesheim B-I, Berg K. High levels of Lp(a) lipoprotein in a family with cases of severe pre-eclampsia. Clin Genet 1996; 50: 47-9.
17 Wang J, Mimuro S, Lahoud R, Trudinger B, Li Wang X. Elevated levels of lipoprotein(a) in women with preeclampsia. Am J Obstet Gynecol 1998; 178: 146-9.
18 Leerink CB, de Vries CV, van der Klis FR. Elevated levels of serum lipo-protein(a) and apolipoprotein(a) phenotype are not related to pre-eclampsia. Acta Obstetricia et Gynecologica Scandinavica 1997; 76: 625-8.
19 Sibai BM. The (H)ELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): Much ado about nothing?. Am J Obstet Gynaecol 1990; 162: 311-6.
20 Labeur G, Michiels G, Bury J, Usher DC, Rosseneu M. Lipoprotein(a) quantified by an enzyme-linked immuno sorbent assay with monoclonal antibodies. Clin Chem 1989; 35: 1380-4.
21 Pijnenborg R, Anthony J, Davey DA. et al. Placental bed spiral arteries in the hypertensive disorders of pregnancy. Br J Obstet Gynaecol 1991; 98 (07) 648-55.
22 Haenggi W, Riesen W. Birkhaeuser, Postmenopausal hormone replacement therapy with tibolone decreases serum lipoprotein(a). Eur J Clin Chem Clin Biochem 1993; 31: 645-50.
23 Soma MR, Osnago-Gadda I, Paoletti R. et al. The lowering of lipoprotein(a) induced by estrogen plus progesterone replacement therapy in postmenopausal women. Arch Int Med 1993; 153: 1462-8.
24 Kronenberg F, Uterman G, Dieplinger H. Lipoprotein(a) in renal disease. Am J kidney dis 1996; 27: 1-25.
25 Feely J, Barry M, Keeling PWN. et al. Lipoprotein(a) in cirrhosis. BMJ 1992; 304: 545-6.
26 Hustin J, Jauniaux E, Schaaps JP. Histological study of the materno-embryonic interface in spontaneous abortion. Placenta 1990; 11: 477-86.