Serum lipoproteins, insulin, and urinary prostanoid metabolites in normal and hypertensive pregnant women

Obstet Gynecol. 1995 Mar;85(3):353-6. doi: 10.1016/0029-7844(94)00380-V.


Objective: To determine if hyperinsulinemia, hypertension, hypertriglyceridemia, and low levels of high-density lipoprotein (HDL) cholesterol are present in women with pregnancy-induced hypertension or preeclampsia.

Methods: Serum concentrations of insulin, uric acid, total and lipoprotein cholesterol, triglyceride, and apolipoproteins A-I and B were measured in 31 women with pregnancy-induced hypertension (eight with proteinuria) and in 21 healthy, pregnant, weight-matched controls at 30-39 weeks' gestation. The urinary excretion of the stable metabolites of prostacyclin (PGI2) (6-keto-prostaglandin [PG] F1 alpha and 2,3-dinor-6-keto-PGF1 alpha) and thromboxane A2 (TxA2) (thromboxane B2 and 2,3-dinor-thromboxane B2) was assessed in 17 women with pregnancy-induced hypertension and in eight controls.

Results: Women with pregnancy-induced hypertension exhibited 18% lower mean serum HDL2 cholesterol levels (0.9 versus 1.1 mmol/L, P < .05) and 65% higher mean triglyceride levels (3.3 versus 2.0 mmol/L, P < .05) compared to controls, whereas other serum lipid and apolipoprotein values did not differ significantly in the two groups. Mean serum insulin levels (13.3 versus 6.5 mU/L, P < .01) and uric acid levels (339.7 versus 231.2 mumol/L, P < .01) in patients with pregnancy-induced hypertension were significantly higher than those in the controls. Urinary output of PGI2 metabolites was reduced by 35-45% in patients with pregnancy-induced hypertension, whereas no differences were seen in the excretion of TxA2 metabolites. Serum HDL2 cholesterol concentrations correlated positively with 2,3-dinor-6-keto-PGF1 alpha excretion, and serum triglyceride concentrations correlated positively with 2,3-dinor-thromboxane B2 excretion. In addition, insulin levels correlated positively with triglyceride levels but negatively with HDL2 cholesterol concentrations.

Conclusion: The metabolic characteristics (hypertriglyceridemia, hyperinsulinemia, hyperuricemia, low HDL2 cholesterol) in pregnancy-induced hypertension resemble the main features of the "insulin resistance syndrome." This may result in endothelial cell dysfunction as evidenced by PGI2 suppression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apolipoprotein A-I / blood
  • Apolipoprotein A-II / blood
  • Case-Control Studies
  • Cholesterol / blood
  • Epoprostenol / metabolism
  • Epoprostenol / urine*
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / metabolism*
  • Hypertension / urine
  • Insulin / blood*
  • Insulin Resistance
  • Lipids / blood*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / blood
  • Pregnancy Complications, Cardiovascular / metabolism*
  • Pregnancy Complications, Cardiovascular / urine
  • Thromboxane A2 / metabolism
  • Thromboxane A2 / urine*
  • Triglycerides / blood
  • Uric Acid / blood


  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Insulin
  • Lipids
  • Triglycerides
  • Uric Acid
  • Thromboxane A2
  • Cholesterol
  • Epoprostenol