Maternal cholesterol levels during gestation: boon or bane for the offspring?
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Maternal cholesterol levels during gestation: boon or bane for the offspring? V. S. Jayalekshmi1,2 · Surya Ramachandran1 Received: 13 July 2020 / Accepted: 15 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract An increase in cholesterol levels is perceived during pregnancy and is considered as a normal adaptive response to the development of the fetus. In some pregnancies, excessive increase in total cholesterol with high levels of Low-Density Lipoprotein leads to maladaptation by the fetus to cholesterol demands, resulting in a pathological condition termed as maternal hypercholesterolemia (MH). MH is considered clinically irrelevant and therefore cholesterol levels are not routinely checked during pregnancy, as a consequence of which there is scarce information on its global prevalence in pregnant women. Studies have reported that MH during pregnancy can cause atherogenesis in adults emphasizing the concept of in utero programming of fetus. Moreover, Gestational Diabetes Mellitus, obesity and Polycystic Ovary Syndrome are potential risk factors which strengthen combined pathologies in placenta and fetuses of mothers with MH. However, lack of conclusive evidence on cholesterol transport and underlying programming demand substantial research to develop population-based life style strategies for women in their childbearing years. The current review focuses on the mechanisms and outcomes of MH from existing epidemiological as well as experimental data and presents a detailed insight on this novel risk factor of cardiovascular diseases. Keywords Maternal hypercholesterolemia · Placenta · Fetal programming · Atherosclerosis
Introduction Low-density lipoprotein-cholesterol (LDL-c) is an essential lipoprotein for the transport of lipids to the cells of the human system. High levels of LDL-c in circulation lead to hypercholesterolemia, a pathogenic risk factor for cardiovascular diseases (CVDs). Among the 17.8 million deaths reported globally in 2017 due to cardiovascular diseases, 80% occurred in financially weaker countries [1]. The World Health Organization’s “Global Action Plan 2013–2020” for the prevention and control of Non-Communicable Diseases (NCD) aims to reduce 25% of CVD events by 2025. Apart from the classical risk factors such as unhealthy diet, lack of exercise, smoking, alcohol intake and genetic causes, * Surya Ramachandran [email protected] 1
Cardiovascular Diseases and Diabetes Biology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
PhD Program in Biotechnology, Manipal Academy of Higher Education, Manipal, Karnataka, India
2
the increase in triglycerides (TGs) and cholesterols during pregnancy affect both maternal and fetal health. In such conditions, the increased levels of LDL-c can go beyond the physiological levels causing maternal hypercholesterolemia (MH). MH at the time of pregnancy can cause atherogenesis in adults [2, 3], supporting the concept of in utero programming of the fetus. However, MH is cons
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