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

Authors

Barbara J. Meyer, University of WollongongFollow
Frances M. Stewart, University of Glasgow
Elizabeth A. Brown, University of Glasgow
Josephine Cooney, University of Glasgow
Solveig Nilsson, Umea University
Gunilla Olivecrona, Umea University
Jane E. Ramsay, University of Glasgow
Bruce A. Griffin, University of Surrey
Muriel J. Caslake, University of Glasgow
Dilys J. Freeman, University of Glasgow

RIS ID

75594

Publication Details

Meyer, B. J., Stewart, F. M., Brown, E. A., Cooney, J., Nilsson, S., Olivecrona, G., Ramsay, J. E., Griffin, B. A., Caslake, M. J. & Freeman, D. J. 2013, 'Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinemia in the third trimester', Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 2, pp. 643-652.

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.