Analysis of the association of lipid profile parameters in women with first trimester pregnancy loss depending on PAI-1 gene polymorphism

Abstract

Aim - to analyse the levels of lipid metabolism indicators as markers of induction of the inflammatory response, depending on the variant of the detected polymorphism of the plasminogen activator inhibitor-1 (PAI-1) gene, and to study the associations between these indicators, PAI-1 levels and obstetric complications.

Materials and methods. The selected patients (n=115) were divided into 3 groups according to the type of polymorphism: Clinical group I (n=20) - patients with wild-type polymorphism of the РAI-1 gene (675 5G>5G), group II (n=53) - women with heterozygous polymorphism of the РAI-1 gene (675 5G>4G), group III (n=42) - women with homozygous pathological polymorphism of РAI-1 (675 4G>4G). The study was based on bibliosemantic analysis; anamnestic data were evaluated; polymerase chain reaction was used to determine thrombophilia gene polymorphisms; enzyme-linked immunosorbent assay to determine the level of РAI-1 in the blood serum; enzymatic colourimetric method for determining the levels of total cholesterol and its fractions, triglycerides.

Results. The average age of women in the thematic groups was comparable and amounted to 32.5±0.9, 33.9±0.7 and 33.6±0.7 years, respectively. The study of the association between plasma RAI-1 concentration, PAI-1 gene polymorphisms and lipid profile parameters in the case study pregnant women confirmed the presence of significant correlations between them. In particular, it was found that elevated levels of total cholesterol and its low-density lipoprotein cholesterol fraction directly correlated with both high PAI-I concentration and PAI-1 gene polymorphisms.

Conclusions. Hypercholesterolemia suggests the possibility of forming zones of atherosclerotic damage to the blood vessels. In the context of early reproductive losses, this fact is important in predicting the possible development of endothelial dysfunction in the uterine spiral vessels. The synergistic effect of high levels of RAI-1, cholesterol and its fractions contributes not only to early and late pregnancy loss, but can also be considered as a cause of ideopathic infertility and in vitro fertilisation failure.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.