Phospholipid transfer protein: The link between lipid metabolism and inflammation in healthy pregnancy and pregnancy with cardiometabolic complications

Background: Phospholipid transfer protein (PLTP) regulates high-density lipoprotein (HDL) remodelling by transferring cholesterol and phospholipids and affecting particle size and function. Pregnancy alters lipid metabolism, but the adaptation of PLTP to pregnancy remains poorly understood. This study investigated longitudinal changes in PLTP gene expression and concentration during healthy pregnancy and pregnancy with cardiometabolic complications, and their associations with maternal lipid metabolism and inflammatory status. Methods: We followed 84 healthy and 20 pregnant women who developed gestational diabetes mellitus and hypertensive disorders during pregnancy. PLTP gene expression, PLTP concentration, advanced lipid profile parameters, and inflammatory status were analysed throughout the trimesters. Results: Comparable trajectories of changes in PLTP gene expression and PLTP concentrations were observed in both groups, but PLTP gene expression in the first trimester was significantly lower in the group with complications (p