Apolipoprotein E Genotypes, Lipid Peroxidation, and Antioxidant Status among Mild and Severe Preeclamptic Women from Western Iran: Protective Role of Apolipoprotein ε2 Allele in Severe Preeclampsia

Objective. The aim of this study was to examine the association of apolipoprotein E (APOE) genotypes and oxidative stress with the risk of mild and severe preeclampsia. Methods. In a case-control study, 198 women with preeclampsia including 128 women with mild and 70 women with severe preeclampsia and 101 control pregnant women from Western Iran were studied. The APOE genotypes were identified using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method. The serum level of malondialdehyde (MDA) and total antioxidant capacity (TAC) were determined using high-performance liquid chromatography and commercial kits, respectively. Results. The frequency of APOE epsilon 2 allele in severe preeclamptic women (2.1%) was significantly (p = 0.008) lower than that in controls (9.4%). The presence of APOE epsilon 2 allele was associated with around five times decreased risk of severe preeclampsia [ OR - 0.21 (95% CI - 0.6-0.73, p - 0.014)]. A significantly higher serum level of MDA was observed in women with severe (10.87 +/- 4.61 mu M) and mild (9.81 +/- 3.67 mu M) preeclampsia compared with that in controls. A trend toward decrease serum level of MDA was observed according to the APOE alleles as epsilon 2 < epsilon 3 < epsilon 4 (9.23, 10.22, and 10.43 mu M, respectively). In preeclamptic women, an inverse correlation was detected between serum levels of MDA and HDL-C (r = -0.16, p = 0.029). However, there was a direct correlation between serum level of MDA with diastolic blood pressure (r = 0.15, p = 0.037). Conclusion. Our study in a population with Kurdish ethnic background indicates a protective role for APOE epsilon 2 allele against severe preeclampsia that might be through high antioxidant capacity of this allele.