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Low-Density Lipoprotein Particle Size Decreases During Normal Pregnancy in Association With Triglyceride Increases

Magee-Womens Research Institute; Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Magee-Women's Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213 hubelc+{at}pitt.edu

Yasser Shakir

Marcia J. Gallaher, MS

Margaret K. McLaughlin, PhD

James M. Roberts, MD

Magee-Womens Research Institute; Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania

Objective: To characterize the changes in low-density lipoprotein (LDL) peak particle diameter (diameter of the predominant LDL subclass) in relation to changes in serum triglyceride concentration during successive stages of normal gestation and postpartum.

Methods: Nonfasting venous blood was obtained longitudinally during and after uncomplicated primiparous pregnancy from 10 nonsmoking women with no history of metabolic disorders. Plasma LDL diameter was determined by nondenaturing polyacrylamide gel electrophoresis. Serum concentrations of total cholesterol, triglyceride, apolipoprotein B, apolipoprotein A-I, and LDL-cholesterol were measured. Gestational changes were analyzed by one-way repeated measures analysis of variance and the paired multiple comparison Student-Neuman-Keuls test. Pearson coefficients were compared for correlation of serum lipids and LDL diameter.

Results: Low-density lipoprotein diameter decreased progressively with advancing gestation, evident by 16-20 weeks relative to 5-12 weeks. Seven of 10 cases were subclass pattern B (diameter less than 255 Å) by term, indicating that small, dense particles predominated. The average diameter decrease from only to late gestation was 13 Å. All subjects reverted to subclass pattern A (diameter 255 Å or more) by 6-12 weeks postpartum, indicating prevalence of large, buoyant LDL. Low-density lipoprotein diameter correlated inversely with concentrations of serum triglyceride (r = -.61, P < .0001), apo B (r = -.66, P < .0001), cholesterol (r = -.53, P < .001), LDL cholesterol (r = -.45, P < .005), and apo A-I (r = -.39, P < .02).

Conclusion: Gestational triglyceride increases are accompanied by progressive decreases in LDL diameter in a majority of cases. These changes undergo reversal postpartum and therefore are transient. Small, dense LDL particles have a number of properties capable of altering vascular function. However, the consequences of the gestational LDL size decrease for maternal and fetal metabolism remain unknown.

Key Words: Pregnancy • low-density lipoprotein subspecies • gradient gel electrophoresis • triglycerides • apolipoproteins

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