1188-P: Plasma ANGPTL4 Is Higher in Women with Advanced Maternal Age and Is Associated with Metabolic Disorders during Pregnancy and the Risk of Adverse Pregnancy Outcomes

Background: Advanced maternal age (AMA) is correlated with a higher risk of metabolic disorders during pregnancy, including gestational diabetes (GDM), gestational hypertriglyceridemia (GHTG), pregnancy-induced hypertension (PIH), and preeclampsia while the pathophysiology remains unclear. Angiopoietin-like protein 4 (ANGPTL4) is a lipoprotein lipase inhibitor which participates in the pathophysiology of metabolic disorders in non-pregnant population. We explored the role of ANGPTL4 in the link between AMA and metabolic disorders during pregnancy.

Method: We recruited 571 pregnant women from November 2013 to April 2018 in National Taiwan University Hospital, Taiwan. ANGPTL4 expression level in placenta and maternal plasma ANGPTL4 level were measured. The correlations among age, plasma ANGPTL4 level, metabolic disorders during pregnancy, and adverse pregnancy outcome were analyzed.

Result: Compared with women aged <30 years, women aged ≥40 years had higher body mass index (BMI), fasting plasma glucose, hemoglobin A1c, insulin resistance index, plasma triglyceride, blood pressure, and plasma ANGPTL4 level in the first trimester. The expression level of ANGPTL4 were higher in the placenta of women with AMA than in the placenta of women aged <30 years. The pregnant women with the highest quartile of plasma ANGPTL4 level had more metabolic disorders during pregnancy. Besides, higher plasma ANGPTL4 was associated with a higher risk of delivering neonates with large for gestational age and the presence of adverse pregnancy outcomes.

Conclusion: Plasma ANGPTL4 is higher in women with AMA and is associated with metabolic disorders during pregnancy and the risk of adverse pregnancy outcomes.