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Lipoprotein lipase concentration in umbilical cord blood reflects neonatal birth weight
Rieko Sagara1, Satoshi Hirayama2, Tsuyoshi Ueno1
1Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
Insights
Maternal insulin resistance during pregnancy affects lipid metabolism. Umbilical cord blood lipoprotein lipase (LPL) concentration, not maternal levels, significantly impacts neonatal birth weight.
Area of Science:
- Obstetrics and Gynecology
- Metabolic Research
- Neonatal Development
Background:
- Pregnancy naturally increases insulin resistance (IR) due to hormonal changes.
- Maternal lipids influence fetal growth, but direct transfer of triglyceride-rich lipoproteins (TGRLs) is not possible.
- Understanding TGRL catabolism and lipoprotein lipase (LPL) synthesis during pregnancy IR is limited.
Purpose of the Study:
- To investigate the relationship between maternal and umbilical cord blood (UCB)-LPL concentrations.
- To assess associations with maternal metabolic parameters.
- To determine the impact on fetal development and neonatal birth weight.
Main Methods:
- Studied 69 pregnant women, measuring anthropometric, lipid, glucose, and insulin parameters.
- Quantified maternal and UCB-LPL concentrations throughout pregnancy.
- Analyzed the correlation between these parameters and neonatal birth weight.
Main Results:
- Glucose metabolism parameters remained stable, while lipid metabolism and IR parameters changed significantly, especially in the second and third trimesters.
- Maternal LPL concentration decreased by 54% by the third trimester.
- UCB-LPL concentration was approximately double the maternal LPL concentration and was a significant determinant of neonatal birth weight, alongside placental weight.
Conclusions:
- Umbilical cord blood LPL concentration is a key indicator of neonatal development.
- Neonatal LPL levels reflect developmental status in the context of declining maternal LPL concentrations during pregnancy.
Background:
Insulin resistance (IR) is exacerbated during pregnancy via increases in insulin counterregulatory hormones. Maternal lipids are strong determinants of neonatal growth, although triglyceride-rich lipoproteins (TGRLs) cannot be transferred directly to the fetus through the placenta. The catabolism of TGRLs under physiological IR and the reduced synthesis of lipoprotein lipase (LPL) are poorly understood. We examined the association of maternal and umbilical cord blood (UCB)-LPL concentrations with maternal metabolic parameters and fetal development.
Methods:
Changes in anthropometric measures and lipid-, glucose-, and insulin-related parameters, including maternal and UCB-LPL concentrations, were examined in 69 women during pregnancy. The relationship between those parameters and neonatal birth weight was assessed.
Results:
Parameters reflecting glucose metabolism did not change during pregnancy, whereas those associated with lipid metabolism and IR changed markedly, particularly in the second and third trimesters. In the third trimester, the maternal LPL concentration gradually decreased, by 54%, whereas the UCB-LPL concentration was ∼2-fold higher than the maternal LPL concentration. Univariate and multivariate analyses showed that the UCB-LPL concentration was a significant determinant of neonatal birth weight, together with placental birth weight.
Conclusion:
The LPL concentration in UCB reflects neonatal development under a decreased LPL concentration in maternal serum.
