ANGPTL3 Levels in Healthy and Mild Preeclamptic Pregnant Women

Introduction: Throughout normal pregnancy, different metabolic and hormonal adaptations are presented, among others, significant modifications in the profile of lipids and lipoprotein metabolism. On the other hands, Angiopoietin-like protein 3 (ANGPTL3) are involved in the regulation of triglyceride metabolism in the fed state by inhibiting the enzyme lipoprotein lipase in oxidative tissues. Objective: Thus, the objective of this study was to determine the profile of serum ANGPTL3 levels during three periods of gestation and three months after delivery. Design, setting and Participants: Serum ANGPTL3 levels were analyzed by ELISA, throughout pregnancy in a case-control study nested within a longitudinal prospective cohort of healthy pregnant (n = 52) and mild preeclamptic women (n = 20), women in the third month postpartum (n = 20) and healthy non-pregnant women (n = 20). The results obtained were correlated with biochemical, hormonal, and anthropometric variables. Results: A significant reduction in ANGPTL3 levels was observed from the first to the third trimesters of pregnancy in healthy and preeclamptic pregnant women when compared with healthy non-pregnant and postpartum women (p<0.01). There were no significant differences in serum ANGPTL3 levels between normal and preeclamptic women. Serum ANGPTL3 levels were positively correlated with triglyceride, very-low-density lipoprotein cholesterol, and total cholesterol levels in healthy non-pregnant (p<0.05); whereas there were no significant correlations between ANGPTL3 with the same variables in healthy and preeclamptic pregnant women. Besides, there were no significant correlations between serum ANGPTL3 with body mass index, high-density lipoprotein cholesterol, glucose, insulin, leptin or HOMA-IR in the study groups described above. Conclusions: The results of the present study show for the first time that ANGPTL3 could be playing a fundamental role in the homeostasis of lipid metabolism throughout gestation. Thus, low levels of ANGPTL3 during pregnancy might favor the accumulation of lipid in oxidative tissues as a deposit of maternal energy source, while preserving glucose and amino acids for the fetus.

Clinical, serologic, and immunogenetic characterization (HLA-DRB1) of late-onset lupus erythematosus in a Colombian population

INTRODUCTION

Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup that is defined as onset after 50 years of age. Late-onset lupus may have a different clinical course and serological findings, which may delay diagnosis and timely treatment.

OBJECTIVES

The objective of this paper is to determine the clinical, serologic, and immunogenetic differences among Colombian patients with late-onset SLE versus conventional SLE patients.

METHODOLOGY

This was a cross-sectional study in a Colombian population. Patients and their medical records were analyzed from the services of Rheumatology in Bogotá and met the criteria for SLE, according to the American College of Rheumatology (ACR) revised criteria for the classification of SLE.In a reference group of late-onset SLE patients (98 participants, with an onset after 50 years of age) and a group of conventional SLE patients (72 participants, with an onset of age of 49 years or less), multiple clinical variables (age, clinical criteria for lupus, alopecia, weight loss, fever, Raynaud's phenomenon) and multiple serological variables (blood count, blood chemistry profile, autoantibodies) were analyzed. Additionally, the HLA class II (DRB1) of all the patients was genotyped, including an additional group of patients without the autoimmune disease. Statistical analysis was performed using the STATA 10.0 package.

RESULTS

In the group of late-onset lupus, there was a higher frequency of pleurisy (p = 0.002), pericarditis (p = 0.026), dry symptoms (p = 0.029), lymphopenia (p = 0.007), and higher titers of rheumatoid factor (p = 0.001) compared with the group of conventional SLE. Late-onset SLE patients had a lower seizure frequency (p = 0.019), weight loss (p = 0.009), alopecia (p < 0.001), and Raynaud's phenomenon (p = 0.013) compared to the conventional SLE group. In late-onset SLE, HLA DR17 (DR3) was found more frequently compared with individuals without autoimmune disease (OR 3.81, 95% CI 1.47 to 10.59) (p = 0.0016).

CONCLUSION

In the Colombian SLE population analyzed, there may be a probable association of several clinical and serologic variants, which would allow the differentiation of variables in the presentation of the disease among patients with late-onset SLE vs. conventional SLE.

Serum chemerin levels during normal human pregnancy

During gestation there are important changes in maternal metabolism and an increase in insulin resistance, coinciding with an increase in adiposity. Chemerin is an adipocytokine which is expressed and secreted in various tissues, including placenta, and may play an important role in metabolic regulation during pregnancy. The aim of this study was to determine serum levels of chemerin during gestation and compare them to other indicators of insulin resistance. A cross-sectional study was carried out analyzing serum chemerin levels of 20 pregnant women during three gestational periods, early, middle, and late (between the 10th and 14th, the 23rd and 26th, and the 34th and 37th week) and 20 non-pregnant women were used as a control group. An analysis of chemerin levels during the menstrual cycle was performed in an eumenorrheic group (n=16) in the early follicular (cycle day 4±1) and the midluteal phase (cycle day 22±1), demonstrating that serum chemerin levels did not fluctuate significantly. Serum levels of chemerin were significantly elevated during late gestation when compared to early (P<0.001) and middle (P=0.001) gestation and a negative correlation between serum chemerin and adiponectin levels (r=-0.1643) became more significant when the non-pregnant group was included in the calculations (r=-0.2471). There was no significant association of triglycerides, total cholesterol, LDL, HDL, insulin, and HOMA levels with chemerin. Although chemerin rose significantly and is negatively associated with adiponectin levels, it is not correlated with other markers of insulin sensitivity, suggesting that more study is needed to determine whether chemerin is useful in predicting insulin resistance during gestation.