Pregnancy-related hyperlipidemia and endothelial function in healthy women

Background The purpose of the present study was to investigate pregnancy-related changes in the maternal serum lipid profile and endothelial function. Methods and Results As part of the population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland, 57 pregnant Finnish women and 62 control women matched for age and smoking were examined throughout gestation. Serum triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined and concomitantly endothelium-dependent brachial artery flow mediated dilation (FMD) was measured by ultrasound. During pregnancy serum TC, LDL-C, HDL-C, TG and very-low-density lipoprotein cholesterol increased significantly when compared with the non-pregnant state (p < 0.001 for each) and towards the end of pregnancy (p < 0.001, p < 0.001, p=0.007, p < 0.001, p < 0.001). FMD increased towards the end of pregnancy and there was a statistically significant direct correlation between gestational age and FMD% (r=0.345, p=0.010). Brachial artery diameter at rest and FMD% were negatively correlated in pregnant (r=-0.280, p=0,035) and non-pregnant women (r=-0.360, p < 0.004). The univariate correlation analysis showed a direct correlation between maternal serum TC (r=0.333, p=0.012) and TG (r=0.366, p=0.006) and FMD%, whereas a negative non-significant correlation was found in non-pregnant women. In a multivariate model, vessel size (beta=-0.436, p=0.001) and TG (beta=0.502, p < 0.001) were the most powerful predictors for FMD% in pregnancy, the influence of other lipids was non-significant. Conclusions In healthy pregnant women increased gestational age is associated with improved endothelium-dependent vasodilation responses regardless of concurrently appearing lipid changes.