The Relation between Deregulated Immune Milieu and Atherogenic Lipids Might Underlie the Development of Pregnancy-induced Hypertensive Disorders

Objectives: Evaluation of the relation between plasma lipoprotein(a) (LPA) and serum tumor necrosis factor-α (TNF-α) levels estimated in blood samples (S1 sample) obtained at the 6th gestational week (GW; T1 time) and the development of preeclampsia (PE) as judged by blood pressure measures at the time of diagnosis of PE (T2 time). Patients and Methods: 140 newly pregnant women gave S1 sample at T1 time; during pregnancy 19 women developed early-onset PE (EOPE) and 51 women developed late-onset PE (LOPE); 16 women developed severe PE (SPE) and 54 women developed mild PE (MPE), while 70 women were normotensive (NT) till the end of pregnancy. At T2 time, all patients gave S2 sample for ELISA estimation of plasma LPA and serum TNF-α level in both samples. Results: Serum TNF-α and plasma LPA levels were significantly higher in all S2 than S1 samples, in both samples of PE than NT women, and in both samples of women who developed EOPE and/or SPE than in samples of women who developed LOPE and/or MPE, respectively. Regression analysis of T1 data defined high body mass index; BMI (β=0.162, P=0.028), high S1 levels of TNF-α (β=0.424, P <0.001), and LPA (β=0.314, P <0.001) as predictors for development of PE as judged by SBP measures at T2 time. Correlation analysis showed a positive significant ( P <0.001) correlation between at-T2-SBP measures with at-T1 BMI and S1 levels of TNF-α and LPA with a positive significant correlation between levels of both variables and with at-T1 BMI. Conclusion: High serum levels of TNF-α and plasma LPA levels early in pregnancy could predict the development of PE and its severity