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Lipoprotein-associated phospholipase A2 is associated with postpartum hypertension in women with history of preeclampsia

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Abstract

Both hypertension and preeclampsia (PE) are considered as inflammatory diseases. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory marker associated with lipid metabolism. We aimed to study the correlation and predictive value of Lp-PLA2 in postpartum hypertension after PE. A group of 160 PE patients (PE group) and a separate group of 160 normal pregnant women (control group) were recruited from January 2010 to October 2011. The average age in the PE group was 28.4 ± 4.5 years and the average gestational age was 34.7 ± 1.1 weeks. The average age in the control group was 27.8 ± 4.5 years and the average gestational age was 35.5 ± 1.2 weeks. General information (including age, gestational age, parity, history of metabolic disease, family history of high blood pressure, height, body weight before childbirth, and blood pressure) and blood samples were collected for measuring Lp-PLA2 and lipid parameters. From February to April in 2013, 153 cases in the PE group and 132 in the control group were re-called. We assessed their postpartum health, pregnancy, height, weight, and blood pressure. Serum mass of Lp-PLA2 in the PE group (210.67 ± 17.98 ng/mL) was significantly higher compared with that in the control group (174.72 ± 30.26 ng/mL) (P < 0.01). The pro-gestation BMI, systolic blood pressure (SBP), diastolic blood pressure, total cholesterol, triglyceride, and low-density lipoprotein-cholesterol (LDL-C) were also significantly higher. Correlation analysis showed that the level of Lp-PLA2 and SBP (r = 0.31), LDL-C (r = 0.37) were positively correlated. The incidence of postpartum hypertension in the PE group was higher than that in the normal control group. Logistic regression analysis showed that prenatal Lp-PLA2 mass was an independent risk factor for PE postpartum hypertension (OR 1.134,95 % CI 1.086–1.185). ROC curve analysis showed that the sensitivity of predicting postpartum hypertension was 73.2 % and the specific degree was 86.6 %, with Lp-PLA2 level of 217.75 ng/mL for boundary value. The onset of postpartum hypertension in PE patients may contribute to vascular inflammation, which is associated with antepartum lipid metabolism.

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References

  1. World Health Organization (2012) World Health Statistics. www.who.int/gho/publications/world_health_statistics/2012/en/

  2. Saito T, Mochizuki T, Uchida K, Tsuchiya K, Nitta K (2013) Metabolic syndrome and risk of progression of chronic kidney disease: a single-center cohort study in Japan. Heart Vessels 28:323–329

    Article  PubMed  Google Scholar 

  3. Craici I, Wagner S, Garovic VD (2008) Preeclampsia and future cardiovascular risk: formal risk factor or failed stress test? Ther Adv Cardiovasc Dis 2(4):249–259

    Article  PubMed Central  PubMed  Google Scholar 

  4. Roberts CL, Ford JB, Algert CS, Antonsen S, Chalmers J, Cnattingius S, Gokhale M, Kotelchuck M, Melve KK, Langridge A, Morris C, Morris JM, Nassar N, Norman JE, Norrie J, Sørensen HT, Walker R, Weir CJ (2011) Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ Open 1(1):e000101

    Article  PubMed Central  PubMed  Google Scholar 

  5. Bellamy L, Casas JP, Hingorani AD, Williams DJ (2007) Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ 335:974–985

    Article  PubMed Central  PubMed  Google Scholar 

  6. Tew DG, Southan C, Rice SQ, Lawrence MP, Li H, Boyd HF, Moores K, Gloger IS, Macphee CH (1996) Purification, properties, sequencing, and cloning of a lipoprotein-associated, serine dependent phospholipase involved in the oxidative modification of low-density lipoproteins. Arterioscler Thromb Vasc Biol 16(4):591–599

    Article  CAS  PubMed  Google Scholar 

  7. Lavi S, Herrmann J, Lavi R, McConnell JP, Lerman LO, Lerman A (2008) Role of lipoprotein-associated phospholipase A2 in atherosclerosis. Curr Atheroscler Rep 10(3):230–235

    Article  CAS  PubMed  Google Scholar 

  8. Lavi S, McConnell JP, Rihal CS, Prasad A, Mathew V, Lerman LO, Lerman A (2007) Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans. Circulation 115(21):2715–2721

    Article  CAS  PubMed  Google Scholar 

  9. Vickers KC, Maguire CT, Wolfert R, Burns AR, Reardon M, Geis R, Holvoet P, Morrisett JD (2009) Relationship of lipoprotein-associated phospholipase A 2 and oxidized low density lipoprotein in carotid atherosclerosis. J Lipid Res 50:1735–1743

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Zalewski A, Macphee C (2005) Role of lipoprotein-associated phospholipase A2 in atherosclerosis: biology, epidemiology, and possible therapeutic target. Arterioscler Thromb Vasc Biol 25(5):923–931

    Article  CAS  PubMed  Google Scholar 

  11. ACOG Committee on Obstetric Practice (2002) ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33. Int J Gynaecol Obstet 77(1):67–75

    Article  Google Scholar 

  12. Krause T, Lovibond K, Caulfield M, McCormack T, Williams B, Guideline Development Group (2011) Management of hypertension: summary of NICE guidance. BMJ 343:d4891

    Article  PubMed  Google Scholar 

  13. Brilakis ES, McConnell JP, Lennon RJ, Elesber AA, Meyer JG, Berger PB (2005) Association of lipoprotein-associated phospholipase A2 levels with coronary artery disease risk factors, angiographic coronary artery disease, and major adverse events at follow-up. Eur Heart J 26(2):137–144

    Article  CAS  PubMed  Google Scholar 

  14. Clausen T, Djurovic S, Henriksen T (2001) Dyslipidemia in early second trimester is mainly a feature of women with early onset pre-eclampsia. BJOG 108(10):1081–1087

    CAS  PubMed  Google Scholar 

  15. Adams MR, Kinlay S, Blake GJ, Orford JL, Ganz P, Selwyn AP (2000) Atherogenic lipids and endothelial dysfunction: mechanisms in the genesis of ischemic syndromes. Annu Rev Med 51:149–167

    Article  CAS  PubMed  Google Scholar 

  16. Dekker GA, Sibai BM (1998) Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol 179(5):1359–1375

    Article  CAS  PubMed  Google Scholar 

  17. Russell R (1999) Atherosclerosis—an inflammatory disease. N Engl J Med 340:115–126

    Article  Google Scholar 

  18. Adiga U, D’souza V, Kamath A, Mangalore N (2007) Antioxidant activity and lipid peroxidation in preeclampsia. J Chin Med Assoc 70(10):435–438

    Article  CAS  PubMed  Google Scholar 

  19. Sesso HD, Buring JE, Chown MJ, Ridker PM, Gaziano JM (2005) A prospective study of plasma lipid levels and hypertension in women. Arch Intern Med 165(20):2420–2427

    Article  PubMed  Google Scholar 

  20. Halperin RO, Sesso HD, Ma J, Buring JE, Stampfer MJ, Michael Gaziano J (2006) Dyslipidemia and the risk of incident hypertension in men. Hypertension 47(1):45–50

    Article  CAS  PubMed  Google Scholar 

  21. de Simone G, Devereux RB, Chinali M, Roman MJ, Best LG, Welty TK, Lee ET, Howard BV, Strong Heart Study Investigators (2006) Risk factors for arterial hypertension in adults with initial optimal blood pressure: the strong heart study. Hypertension 47(2):162–167

    Article  PubMed  Google Scholar 

  22. Laaksonen DE, Niskanen L, Nyyssonen K, Lakka TA, Laukkanen JA, Salonen JT (2008) Dyslipidaemia as a predictor of hypertension in middle-aged men. Eur Heart J 29(20):2561–2568

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Vaziri ND, Rodríguez-Iturbe B (2006) Mechanisms of disease: oxidative stress and inflammation in the pathogenesis of hypertension. Nat Clin Pract Nephrol 2(10):582–593

    Article  CAS  PubMed  Google Scholar 

  24. Niskanen L, Laaksonen DE, Nyyssönen K, Punnonen K, Valkonen VP, Fuentes R, Tuomainen TP, Salonen R, Salonen JT (2004) Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension 44(6):859–865

    Article  CAS  PubMed  Google Scholar 

  25. Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM (2003) C-reactive protein and the risk of developing hypertension. JAMA 290(22):2945–2951

    Article  CAS  PubMed  Google Scholar 

  26. Engström G, Janzon L, Berglund G, Lind P, Stavenow L, Hedblad B, Lindgärde F (2002) Blood pressure increase and incidence of hypertension in relation to inflammation-sensitive plasma proteins. Arterioscler Thromb Vasc Biol 22(12):2054–2058

    Article  PubMed  Google Scholar 

  27. Spaan JJ, Sep SJ, van Balen VL, Spaanderman ME, Peeters LL (2012) Metabolic syndrome as a risk factor for hypertension after preeclampsia. Obstet Gynecol 120(2 Pt 1):311–317

    Article  PubMed  Google Scholar 

  28. Lavi S, McConnell JP, Rihal CS, Prasad A, Mathew V, Lerman LO, Lerman A (2007) Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans. Circulation 115(21):2715–2721

    Article  CAS  PubMed  Google Scholar 

  29. Kotchen JM, McKean HE, Kotchen TA (1982) Blood pressure of young mothers and their children after hypertension in adolescent pregnancy: six-to nine-year follow-up. Am J Epidemiol 115(6):861–867

    CAS  PubMed  Google Scholar 

  30. Taguchi E, Nishigami K, Miyamoto S, Sakamoto T, Nakao K (2014) Impact of shear stress and atherosclerosis on entrance-tear formation in patients with acute aortic syndromes. Heart Vessels 29:78–82

    Article  PubMed Central  PubMed  Google Scholar 

  31. Nguyen TT, Adair LS, He K, Popkin BM (2008) Optimal cutoff values for overweight: using body mass index to predict incidence of hypertension in 18- to 65-year-old Chinese adults. J Nutr 138(7):1377–1382

    PubMed  Google Scholar 

  32. Kuklinska AM, Mroczko B, Musial WJ, Usowicz-Szarynska M, Sawicki R, Borowska H, Knapp M, Szmitkowski M (2009) Diagnostic biomarkers of essential arterial hypertension: the value of prostacyclin, nitric oxide, oxidized-LDL, and peroxide measurements. Int Heart J 50(3):341–351

    Article  CAS  PubMed  Google Scholar 

  33. Kajiya M, Miyoshi T, Doi M, Usui S, Iwamoto M, Takeda K, Nosaka K, Nakayama R, Hirohata S, Kusachi S, Nakamura K, Ito H (2013) Serum adipocyte fatty acid-binding protein is independently associated with complex coronary lesions in patients with stable coronary artery disease. Heart Vessels 28:696–703

    Article  PubMed  Google Scholar 

  34. Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, Newby LK, Piña IL, Roger VL, Shaw LJ, Zhao D, Beckie TM, Bushnell C, D’Armiento J, Kris-Etherton PM, Fang J, Ganiats TG, Gomes AS, Gracia CR, Haan CK, Jackson EA, Judelson DR, Kelepouris E, Lavie CJ, Moore A, Nussmeier NA, Ofili E, Oparil S, Ouyang P, Pinn VW, Sherif K, Smith SC Jr, Sopko G, Chandra-Strobos N, Urbina EM, Vaccarino V, Wenger NK (2011) Effectiveness-based guidelines for the prevention of cardiovascular disease in women–2011 update: a guideline from the American heart association. Circulation 123(11):1243–1262

    Article  PubMed Central  PubMed  Google Scholar 

  35. Tobaru T, Seki A, Asano R, Sumiyoshi T, Hagiwara N (2013) Lipid-lowering and anti-inflammatory effect of ezetimibe in hyperlipidemic patients with coronary artery disease. Heart Vessels 28:39–45

    Article  PubMed  Google Scholar 

  36. Tsimihodimos V, Tselepis AD (2010) Effect of cardiovascular drugs on the plasma levels of lipoprotein associated phospholipase A2 (Lp-PLA2). Open Clin Chemi J 3:60–65

    Article  CAS  Google Scholar 

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Acknowledgment

This study was supported by a grant from Guangdong Science and Technology Department, Fund Code: 2011B31800264.

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Authors and Affiliations

  1. Guangdong Women and Children Hospital, 13 Guang Yuan Xi Road, Guangzhou, Guangdong province, 510010, People’s Republic of China

    Yuheng Zhou, Jianmin Niu, Dongmei Duan, Qiong Lei, Jiying Wen, Xiaohong Lin, Lijuan Lv & Longding Chen

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  1. Yuheng Zhou
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  2. Jianmin Niu
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Correspondence to Jianmin Niu.

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Y. Zhou and J. Niu contributed equally to this work.

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Zhou, Y., Niu, J., Duan, D. et al. Lipoprotein-associated phospholipase A2 is associated with postpartum hypertension in women with history of preeclampsia. Heart Vessels 30, 503–509 (2015). https://doi.org/10.1007/s00380-014-0514-7

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