Evidence of inflammation and predisposition toward metabolic syndrome after pre-eclampsia

Abstract

Background: Pre-eclampsia (PE) is a hypertensive disorder of pregnancy characterized by exaggerated inflammatory and metabolic responses. Women with a history of PE are at increased risk of the metabolic syndrome (MetS) and cardiovascular disease although the pathophysiological underpinnings of this association remain unclear. This study aimed to compare levels of plasma immunoregulatory factors with the presence of cardiovascular and MetS risk factors in women with and without a history of PE.

Study design: Maternal plasma and general health survey data were collected from women 5 to 7months postpartum of uncomplicated pregnancies (n=28) and pregnancies complicated by PE (n=35). Maternal plasma samples were analyzed for 14 immunoregulatory factors using a high-sensitivity cytokine profiling array. Cardiovascular risk profiles were compiled on each participant for comparison against cytokine data.

Results: Women with a history of PE exhibited increased blood pressure and plasma triglyceride levels compared to controls, although similar for parameters of obesity, fasting cholesterols, and glucose. While plasma levels of immunoregulatory cytokines were similar between control and PE subjects, PE subjects exhibited unique patterns of correlation between biophysical parameters and plasma cytokines. In particular, plasma IL-23, MIP-1α, IL-1β and IFN-γ levels were significantly correlated with parameters considered for MetS diagnosis in women without clinical evidence of the syndrome.

Conclusions: We report unique associations between pro-inflammatory markers and MetS criteria within a year following PE. Subclinical inflammation in women with a history of PE who are otherwise healthy may indicate a sensitization of these women toward metabolic disturbances, in particular MetS.

Keywords: Inflammation; Metabolic syndrome; Pre-eclampsia.