Reduced hepatic LDL-receptor, 3-hydroxy-3-methylglutaryl coenzyme A reductase and sterol carrier protein-2 expression is associated with pregnancy loss in the diabetic rat.

Hepatic low density lipoprotein receptor (LDLR), 3-hydroxy-3-methylglutaryl coenyzme A reductase (HMGR), cholesterol 7α-hydroxylase, and sterol carrier protein-2 are important proteins associated with the uptake, synthesis, degradation and transport of cellular cholesterol. Since cholesterol is critically important for steroid hormone synthesis and is an essential component in membrane biosynthesis, this study investigated whether these proteins are altered in the normal pregnant and streptozotocin (STZ)-induced diabetic pregnant rat. The goal of these experiments was to determine whether diabetic reproductive dysfunction is associated with a significant change in maternal cholesterol homeostasis. Diabetic animals were grouped based on their ability or inability to maintain pregnancy up to day 15 post-conception. LDLR and HMGR mRNA levels were significantly reduced in animals which did not maintain pregnancy whereas diabetic animals with fetuses had normal LDLR and HMGR mRNA levels. Hepatic LDLR, HMGR, and SCP2 protein levels were examined in normal pregnant and diabetic pregnant animals by Western blot analysis. SCP2 levels were reduced in all diabetic animals, particularly in the diabetic animals which lost their fetuses. The decline in SCP2 was associated with an increase in sterol carrier protein-X (SCPx), a protein related to SCP2. SCPx has been shown to have thiolytic activity and is thought to have a role in β-oxidation of fatty acids. HMGR was also significantly reduced in diabetic animals which lost their fetuses. Cholesterol 7α-hydroxylase mRNA was slightly, but not significantly, reduced in all diabetic animals. Serum very low density lipoprotein (VLDL) +LDL cholesterol increased significantly in the STZ-treated diabetic rats while the HDL cholesterol levels declined in these animals. Reduced hepatic LDLR and HMGR mRNA levels were consistently associated with reduced serum progesterone and an inability to maintain pregnancy. The results of this study suggest that the maintenance of maternal cholesterol metabolism is a critical factor directly associated with successful pregnancy outcome in the diabetic rat.