Molecular Genetic Determinants of Impaired Lipid Metabolism in the Pathogenesis of Preeclampsia

Aim. To study the role of lipid metabolism gene polymorphism and changes in the lipid-transporting lipid system in patients with moderate to severe preeclampsia (PE).

Design. Prospective cohort comparative study.

Materials and methods. We analysed results of clinical, anamnestic and laboratory examination of 130 patients with a high risk of PE, following a prenatal diagnostics performed during the first trimester. The patients were divided into three groups: with actual severe PE (group I, n = 53, weeks 23 to 38 of pregnancy); with actual moderate PE (group II, n = 45, weeks 28 to 40 of pregnancy), and without PE (control group, or group III, n = 32, weeks 28 to 40 of pregnancy).

During the clinical examination, somatic and obstetric-gynaecological history was taken, and the present pregnancy was reviewed. A sample for blood biochemistry was drawn upon hospitalisation; the analysis included lipid parameters (cholesterol, triglycerides, high, low and very low-density lipoproteins), total bilirubin, urea, creatinine, apolipoproteins (АроА, АроВ). Sample genotyping was performed using the realtime polymerase chain reaction with a reagent kit and protocol for genetic polymorphisms.

Results. The results show that the most informative parameters of dyslipidaemia in pregnant women, which are associated with the risk of PE, are high levels of very low-density lipoproteins, atherogenic index of over 3.5 and ApoB/ApoA index of over 0.9.

The presence of allele T of polymorphic locus ApoE rs429358 in homo- or heterozygous state in the genotype increases the risk of PE, while genotype СС of polymorphism ApoE rs429358 has a protective effect against this pathology. Genotype AA of polymorphism rs708272 of gene CETP (G>A) has also a protective effect, while the presence in the genotype of at least one variant of allele G of this locus increases the risk of PE.

Conclusion. The study demonstrates the importance of lipid transport system parameters, especially the ratio of apolipoproteins and various density lipoproteins, as well as polymorphisms ApoE T>C, CETP G>A in the pathogenesis and diagnosis of PE.

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