High-density lipoprotein and homocysteine levels correlate inversely in preeclamptic women in northern Nigeria

Background. Preeclampsia/eclampsia is one of the most common complications of pregnancy. It is a cause of high morbidity for both mother and fetus, especially in developing countries. In a recent survey conducted in Gombe, Nigeria, eclampsia was found to be a major cause of maternal mortality (24.2%), second only to obstetric hemorrhage (27.1%). Previous studies have produced contradictory findings regarding total homocysteine (tHcy) levels in women with preeclampsia/eclampsia and there is little information about the relationship between particular serum lipids and tHcy. The objective of this study in Gombe was to compare the levels of serum lipids and homocysteine in healthy pregnant women and women with preeclampsia/eclampsia in Nigeria. Methods. The experimental subjects included 43 women with preeclampsia/eclampsia and 130 healthy pregnant women served as controls. The criteria for preeclampsia/ eclampsia included the following: hypertension (blood pressure > 140/90 mmHg), total protein (> 190mg/g creatinine), and edema. Blood sera obtained from patients and controls attending the prenatal clinics at the Specialist Hospital and the Federal Medical Center in Gombe were analyzed for tHcy, total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, antioxidant capacity, folate, and vitamin B-12. Results. The mean tHcy concentration for the preeclamptic/ eclamptic women was greater than that of the controls (10.1 vs. 8.4 μmol/l, respectively, p = 0.01). The mean concentrations of LDL-cholesterol and triacylglycerols were not different between the two groups. However, the mean HDL-cholesterol level was higher in the healthy pregnant women compared with the preeclamptic/eclamptic women (1.64 vs. 1.42mmol/l, respectively, p = 0.02). The HDL-cholesterol concentration was correlated inversely with the tHcy concentration (p = 0.001, r = 0.51). Total homocysteine was not linked with either serum folate or vitamin B-12. Conclusions. These results show that preeclampsia/eclampsia is associated with increased tHcy levels and that HDL levels are depressed in Nigerian women with this hypertensive, pregnancy associated disorder. © Acta Obstet Gynecol Scand 83 2004.