Altered Metabolic Profiles Among Older Mothers With a History of Preeclampsia

Abstract

Preeclampsia has been associated with an increased risk of cardiovascular disease and also with a lowered risk of breast cancer later in life. These associations may represent underlying metabolic changes. The investigators undertook a case-control study in which metabolic profiles were examined in women who completed their pregnancies at age 30 and older and had no serious chronic disorders. Thirteen women had experienced preeclampsia in their first pregnancies, whereas 13 others had no complications. Preeclampsia was defined as newly developed hypertension of pregnancy exceeding 140/90 mm Hg and proteinuria of at least 0.3 g/24 hours. The groups were matched for race/ethnicity, current age at the time of delivery, and current age. Women having preeclampsia were likelier than control women to be primiparous, tended to be heavier, and had higher resting diastolic blood pressure. There were no significant group differences in age at first delivery, age at first menses, current age, racial/ethnic distribution, a history of breast feeding, or a family history of breast cancer. In the overall group, body mass index correlated positively with serum levels of triglycerides, insulin, and glucose as well as with the fasting insulin resistance index. Women with a history of preeclampsia had significantly higher levels of fasting serum triglycerides, insulin, and glucose, and lower levels of fasting high-density lipoprotein than women without complications. In addition, they had a higher fasting insulin resistance index. A history of preeclampsia correlated with increased levels of insulin-like growth factor-binding protein-3 (IGFBP-3) and a higher ratio of IGFBP-3 to IGF-1 (insulin-like growth factor-1). Controlling for obesity did not substantially alter these associations. Adjusting for obesity or parity did not significantly alter the relationship between past preeclampsia and markers of dyslipidemia or reduced levels of IGF-1. No major differences emerged after excluding obese women. The case and control women had comparable fasting serum levels of total cholesterol and IGF-1. In women having preeclampsia in a former pregnancy, reduced bioavailability of IGF-1, relative insulin resistance, and dyslipidemia may persist. These changes may account, at least in part, for the increased risk of cardiovascular disease as well as the lowered risk of breast cancer observed in these women.