Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO BOX 1072, Blindern, 0316, Oslo, Norway.
Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
Placenta. 2019 Nov;87:23-29. doi: 10.1016/j.placenta.2019.09.001. Epub 2019 Sep 3.
The extent to which the human term fetus utilizes cholesterol released from the placenta has remained elusive. Our aims were to estimate the net mass of cholesterol taken up by the uteroplacental unit, released by the placenta and taken up by the fetus. Thereby we aimed to explore the maternal-fetal cholesterol transfer and hypothesized that maternal levels and uteroplacental uptake were correlated to the fetal uptake of cholesterol.
A cross-sectional in vivo study of 179 fasting, healthy women with uncomplicated singleton pregnancies. Blood flow in the uterine artery (n = 70) and umbilical vein (n = 125) was measured by Doppler ultrasound. Blood samples from the maternal radial artery, antecubital vein and uterine vein, and the umbilical artery and vein were obtained during cesarean section. Cholesterol was determined enzymatically.
We found a significant uteroplacental uptake (median [Q1,Q3]) of total (3.50 [-36.8,61.1]) and HDL cholesterol (6.69 [-3.78,17.9]) μmol/min, and a fetal uptake of HDL (8.07 [4.48,12.59]), LDL (5.97 [2.77,8.92]) and total cholesterol (13.2 [8.06,21.58]) μmol/min. Maternal cholesterol levels were not correlated to fetal uptake of cholesterol. There was a correlation between uteroplacental uptake of total (rho 0.35, p 0.003) and LDL cholesterol (rho 0.25, p 0.03) and the fetal uptake of LDL cholesterol from the umbilical circulation. The fetal uptake of cholesterol from HDL was higher than from LDL (p < 0.001).
Fetal cholesterol uptake is independent of maternal cholesterol levels, but related to the uteroplacental uptake of cholesterol from LDL. This suggests that the placenta influences maternal-fetal cholesterol transfer at term.
胎儿利用胎盘释放的胆固醇的程度仍不清楚。我们的目的是估计胎盘中胆固醇的净摄取量、胎盘释放量和胎儿摄取量。从而探索母体-胎儿胆固醇转移，并假设母体水平和胎盘摄取与胎儿胆固醇摄取相关。
这是一项 179 名空腹、健康、无复杂单胎妊娠的妇女的横断面体内研究。通过多普勒超声测量子宫动脉（n=70）和脐静脉（n=125）的血流。在剖宫产期间从产妇桡动脉、肘前静脉和子宫静脉以及脐动脉和脐静脉采集血液样本。用酶法测定胆固醇。
我们发现胎盘的总胆固醇（中位数[Q1，Q3]）和高密度脂蛋白胆固醇（6.69[-3.78，17.9]）的摄取量有显著差异（μmol/min），以及胎儿对高密度脂蛋白胆固醇（8.07[4.48，12.59]）、低密度脂蛋白胆固醇（5.97[2.77，8.92]）和总胆固醇（13.2[8.06，21.58]）的摄取量。母体胆固醇水平与胎儿胆固醇摄取量无关。胎盘总胆固醇（rho 0.35，p 0.003）和 LDL 胆固醇（rho 0.25，p 0.03）的摄取量与脐循环中 LDL 胆固醇的胎儿摄取量呈正相关。胎儿从 HDL 摄取的胆固醇高于 LDL（p<0.001）。
胎儿胆固醇摄取量与母体胆固醇水平无关，但与胎盘从 LDL 摄取胆固醇有关。这表明胎盘在足月时影响母体-胎儿胆固醇转移。
