title: The influence of ApoE genotype on the lipid profile and lipoproteins during normal pregnancy in a Southern African population.
abstract: BACKGROUND
  Pregnancy is associated with increases in fasting triglycerides and total cholesterol.1 ApoE isoforms are known to influence the concentration of cholesterol, with apoE2 homozygosity lowering and apoE4 homozygosity raising the cholesterol concentration compared with E3 homozygosity.2 The lipid profiles ApoE status and prevalence of small dense LDL species were evaluated for subjects attending an antenatal clinic.
  
  
  RESULTS
  Samples from 690 women aged between 16 and 42 years of age were analyzed during and after pregnancy. The fasting plasma triglyceride concentration (in mmol/L) was significantly higher in pregnancy (median = 1.5, IQR 1.0-2.0 vs median = 0.6, IQR 0.5-0.8 respectively, p < 0.0001). Similarly, the total cholesterol (in mmol/L) was increased during pregnancy (median=4.1, IQR 3.6-4.7 vs median 3.5, IQR 3.1-3.5, respectively p=0.0167). The median LDL cholesterol and HDL cholesterol did not change. Higher proportions of small density LDL species were seen during pregnancy compared to after pregnancy. The distribution of the LDL species during pregnancy and 6 weeks post-partum were significantly different p<0.0001 with the smaller species being much higher during pregnancy.
  
  
  CONCLUSIONS
  ApoE4 genotype was associated with increased total cholesterol and LDL cholesterol concentrations during pregnancy. Pregnancy results in a reversible remodeling of LDL to smaller species, the significance of which is unknown but may indicate a predisposition to atherosclerosis.
authors.affiliation: Division of Human Genetics, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa; Division of Chemical Pathology, Department of Pathology, University of Witwatersrand/ National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
authors.forename: Donald Moshen
authors.initials: DM
authors.lastname: Tanyanyiwa
authors.affiliation: Department of Internal Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Adrian David
authors.initials: AD
authors.lastname: Marais
authors.affiliation: Department of Internal Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Pamela
authors.initials: P
authors.lastname: Byrnes
authors.affiliation: Department of Internal Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Sheena
authors.initials: S
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D001057:Apolipoproteins E; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D001057:Apolipoproteins E; D008074:Lipoproteins
keywords: African; Apolipoprotein E. Lipids; pregnancy; small dense LDL species