Key result
Prior pre-eclampsia is linked to ~55% higher carotid plaque risk via medium VLDL particles.
Why the study?
Persistence of lipoprotein abnormalities in T1D and/or pre-eclampsia could be associated with CVD, but differences in advanced lipoprotein profiles and their differential association with atherosclerosis were unknown.
Are advanced NMR lipoprotein profiles associated with carotid atherosclerosis in women with type 1 diabetes and/or previous pre-eclampsia?
Observational (n=112)
Are advanced NMR lipoprotein profiles associated with carotid atherosclerosis in women with type 1 diabetes and/or previous pre-eclampsia?
Effect estimate: OR 1.550 (95% CI 1.013-2.374)
NMR-derived lipoprotein profiles, particularly LDL and triglyceride-related variables, are differentially associated with carotid atherosclerosis in women with type 1 diabetes and a history of pre-eclampsia.
Supports hypothesis that medium-VLDL mediates pre-eclampsia–related carotid plaque in T1D; prospective validation required before clinical use.
AIMS: Persistence of lipoprotein abnormalities in type 1 diabetes (T1D) and/or pre-eclampsia could be associated with cardiovascular disease (CVD). We assessed differences in the advanced lipoprotein profiles according to the presence of both conditions and their differential association with atherosclerosis. MATERIAL AND METHODS: We recruited 112 women without CVD and last pregnancy ≥5 years previously, divided into four groups (n = 28 per group): (a) T1D and previous pre-eclampsia; (b) T1D without pre-eclampsia; (c) pre-eclampsia without T1D; and (d) controls (without T1D/pre-eclampsia). Groups were matched by several risk factors, and diabetes duration and retinopathy in T1D. Carotid intima-media thickness (IMT) and the presence of plaque (IMT ≥1.5 mm) were assessed by ultrasonography. The lipoprotein profile was evaluated by nuclear magnetic resonance (NMR) spectroscopy. RESULTS: The participants were 44.9 ± 7.8 years old. Carotid plaque presence was 20.5%, with a higher prevalence in T1D and/or pre-eclampsia vs controls (P < .05). High-density lipoprotein (HDL)-related variables differed among groups, mainly driven by an increase in T1D (P < .05), whereas triglyceride-related variables were increased in pre-eclampsia [medium very low-density lipoprotein (VLDL) particles and triglyceride enrichment in HDL and low-density lipoprotein (LDL)]. Overall, in multivariate-adjusted models, LDL-related variables were the most strongly associated with atherosclerosis (P < .05). In age- and statin-adjusted models, previous pre-eclampsia showed an independent association with triglyceride-related variables (plaque: medium-VLDL-particles, OR 1.550 [1.013-2.374]; HDL-cholesterol/HDL-triglycerides ratio, OR 0.411 [0.175-0.967]). Regarding T1D, HDL-parameters were also differentially associated (maximum-IMT: HDL-cholesterol/HDL-particles ratio, β = -.258, P = .036). CONCLUSIONS: NMR lipoproteins were differentially and independently associated with atherosclerosis in T1D/pre-eclampsia. Further studies are needed to ascertain the role of NMR parameters as CVD biomarkers in this high-risk population.
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Amor et al. (2020) conducted an observational in Type 1 diabetes and pre-eclampsia (n=112). Type 1 diabetes and/or previous pre-eclampsia vs. Controls without T1D or pre-eclampsia was evaluated on Carotid intima-media thickness (IMT) and presence of plaque (OR 1.550, 95% CI 1.013-2.374). Previous pre-eclampsia was independently associated with carotid plaque presence via medium-VLDL-particles (OR 1.550; 95% CI 1.013-2.374) in women without prior cardiovascular disease.
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