Divergent metabolic and vascular phenotypes in pre-eclampsia and intrauterine growth restriction: relevance of adiposity.
OBJECTIVE
Pre-eclampsia (PE) and intrauterine growth restriction (IUGR) may both arise secondary to inadequate trophoblast invasion. Maternal vascular disease is evident only in PE. Little mechanistic evidence exists to explain this dichotomy.


METHODS
We employed laser Doppler imaging (LDI) to examine microvascular function in 15 women with PE and 30 healthy pregnant women matched for body mass index (BMI). We also examined 16 women with IUGR. Other factors examined included indices of inflammation, lipoproteins, leptin and insulin concentrations.


RESULTS
Women with PE had double the concentration of leptin and 30% higher triglyceride than controls. Vascular cell adhesion molecule (VCAM)-1 and interleukin (IL)-6 were also higher in women with PE, with both factors correlating with leptin independently of BMI. No difference in microvascular reactivity was observed between controls and women with PE. Women with IUGR had a four-unit smaller BMI than women with PE. When compared with controls, they also had lower low-density lipoprotein cholesterol (LDL-C) concentrations and systemic inflammatory measures were not elevated.


CONCLUSIONS
The technique of LDI is not sensitive to the vascular dysfunction of PE. However, circulating endothelial-derived factors are elevated in association with markedly elevated leptin levels. Therefore, women with IUGR may demonstrate a protective role for their 'leanness' with regard to maternal systemic inflammatory effect.
University Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary, Scotland, UK. jane.ramsay@aaht.scot.nhs.uk
Jane E
JE
Ramsay
William R
WR
Ferrell
Lynne
L
Crawford
A Michael
AM
Wallace
Ian A
IA
Greer
Naveed
N
Sattar
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D015415:Biomarkers; D015243:Cholesterol, VLDL / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D005317:Fetal Growth Retardation / Q000276:immunology* / Q000378:metabolism*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation; D010641:Phenotype; D011225:Pre-Eclampsia / Q000276:immunology* / Q000378:metabolism*; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood; D014657:Vasculitis / Q000276:immunology / Q000378:metabolism; D014664:Vasodilation
D015415:Biomarkers; D015243:Cholesterol, VLDL; D014280:Triglycerides