Abstract
This work was undertaken to investigate correlation between oxidative stress and initiation of pathogenesis of pregnancy induced hypertension (PIH). Fifty primigravidae in age group of 20–35 years and gestational age 28–42 weeks with PIH were taken as cases. Twenty healthy primigravidae with no medical and surgical complications of pregnancy and with blood pressure ≤140/90 mm Hg served as controls. The cases were again subgrouped as severe preeclampsia (12 in number) and mild pre-eclampsia (38 in number). All of them were evaluated for serum malondialdehyde (MDA), Serum vitamin E and plasma vitamin C levels. The serum MDA levels were raised significantly in women with mild preeclampsia (P<0.01) and in women with severe preeclampsia (P<0.01) in comparison to normal primi gravida. The serum vitamin E levels were decreased in primi gravida with mild preeclampsia (p<0.1) and in primi with severe pre eclampsia (P<0.1) in comparison to normal primi gravida but the fall was not statistically significant. There was a significant fall (P<0.05) in the vitamin C levels in primi with mild preeclampsia than in the normal primi. The vitamin C levels in severe preeclamptic patients were lower than the normal primi but the fall was not statistically significant (P=0.10). The serum MDA and vitamin E showed a negative correlation in all the cases. The serum MDA and plasma vitamin C also showed a negative correlation in the control and study group. This observation suggests that in hypertensive disorders of pregnancy there is an imbalance between lipid peroxidation and antioxidant vitamin status because of oxidative stress. The decreased serum concentrations of the antioxidant vitamins supports the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of preeclampsia. The rise in antioxidants is probably to compensate the increased peroxide load in severe preeclampsia.
Key words: Lipid peroxides, vitamin E, ascorbic acid
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Reference
- 1.Sibai B.M. Hypertension in pregnancy. Obstet. Gynecol. Clin. North Am. 1992;19:615–615. [PubMed] [Google Scholar]
- 2.Krishna Menon M.K., Palaniappan B. Hypertensive disorders of pregnancy. In: Menon Mudaliar., editor. Clinical Obstetrics. 9th edn. Madras: Orient Longman; 1994. pp. 133–154. [Google Scholar]
- 3.National High Blood Pressure Education Programme Working Group. 1990.
- 4.Hubel C.A., Roberts J.M., Taylor R.N., et al. Lipid peroxidation in pregnancy: New perspectives on preeclampsia. Am. J. Obstet. Gynecol. 1989;161:1025–1034. doi: 10.1016/0002-9378(89)90778-3. [DOI] [PubMed] [Google Scholar]
- 5.Wang Y., Walsh S.W., Kay H.H. Placental lipid peroxides and thromboxane are increased and prostacyclin is decreased in women with preeclampsia. Am. J. Obstet. Gynecol. 1992;167:946–949. doi: 10.1016/s0002-9378(12)80017-2. [DOI] [PubMed] [Google Scholar]
- 6.Uotila J.T., Tuimala R.J., Aarino T.M., et al. Findings on lipid peroxidation and anti oxidant function in hypertensive complications of pregnancy. Br. J. Obstet. Gynaecol. 1993;100(3):270–276. doi: 10.1111/j.1471-0528.1993.tb15242.x. [DOI] [PubMed] [Google Scholar]
- 7.Wu J.J. Lipid peroxidation in preeclamptic and eclamptic pregnancies. Eur. J. Obstet. Gynecol. Reprod. Biol. 1996;64(1):51–54. doi: 10.1016/0301-2115(95)02270-8. [DOI] [PubMed] [Google Scholar]
- 8.Davidge S.T., Hubel C.A., Brayden R.D., et al. Sera antioxidant activity in uncomplicated and preeclamptic pregnancies. Obstet. Gynecol. 1992;71:897–901. [PubMed] [Google Scholar]
- 9.Wisdom S.J., Wilson R., Mckillop J.H., et al. Antioxidant systems in normal pregnancy and pregnancy induced hypertension. Am. J. Obstet. Gynecol. 1991;165:1701–1704. doi: 10.1016/0002-9378(91)90018-m. [DOI] [PubMed] [Google Scholar]
- 10.Wang Y., Walsh S.W., Gu J., et al. The imbalance between thromboxane and prostacyclin in preeclampsia is associated with an imbalance between lipid peroxides and vitamin E in maternal blood. Am. J. Obstet. Gynecol. 1991;165:1965–1700. doi: 10.1016/0002-9378(91)90017-l. [DOI] [PubMed] [Google Scholar]
- 11.Mikhail M.S., Anyaegbunam A., Garfinkel D., Palan P.R., Basu J., Romney S.L. Preeclampsia and antioxidant nutrients, decreased plasma levels of reduced ascorbic acid, alpha-tocopherol and Beta-Carotene in women with preeclampsia. Am. J. Obstet. and Gynecol. 1994;171(1):150–157. doi: 10.1016/0002-9378(94)90462-6. [DOI] [PubMed] [Google Scholar]
- 12.Iioka H. Changes in blood level of lipid peroxide and Vitamin E during pregnancy clinical significance and relation to the pathogenesis of EPH gestosis. Gynecol. Obstet. Invest. 1994;38:173–176. doi: 10.1159/000292473. [DOI] [PubMed] [Google Scholar]
- 13.Satoh, K. (1978). Clinica. Chemica. Acta. 37–43. [DOI] [PubMed]
- 14.Baker, H., Frank, D. and Winley, N.C. (1968). Clinical vitaminology, 772.
- 15.Harris, Ray . Vitamins in Practical Clinical Biochemistry. 5th edn. London: William Heinmann Medical Books Ltd.; 1935. [Google Scholar]
- 16.Harold Varley. Estimation of urinary proteins by Turbidimetric method using sulphosalicylic Acid. In Practical Clinical Biochemistry (5th edn.). Vol. 1, p. 606.
- 17.Wickens D., Wilkins M.H., Lunec J., Ball G., Dormandy T.L. Free radical oxidation (Peroxidation) products in plasma in normal and abnormal pregnancy. Ann. Clin. Biochem. 1981;18:158–162. doi: 10.1177/000456328101800306. [DOI] [PubMed] [Google Scholar]
- 18.Tsukatani E. Etiology of EPH—gestosis from the view point of dynamics of vasoconstrictive prostanoid, lipid peroxides and vitamin E. Acta. Obstet. Gynecol. Jpn. 1983;35:713–720. [PubMed] [Google Scholar]
- 19.Walsh S.W. Lipid peroxidation in pregnancy, Hypertension in pregnancy. Am. J. Obstet. Gynecol. 1994;13:1–1. [Google Scholar]
- 20.Regan C.L., Levine R.J., Baird D.D., Ewell M.G., Martz K.L., Sibai B.M., Rokach J., Lawson J.A., Fitazgerald G.A. No evidence for lipid peroxidation in severe preeclampsia. Am. J. Obstet. Gynecol. 2001;185(3):572–578. doi: 10.1067/mob.2001.116754. [DOI] [PubMed] [Google Scholar]
- 21.Jain S.K., Wise S.R. Relationship between elevated lipid peroxides, vitamin E deficiency and hypertension in preeclampsia. Molecular and Cellular Biochemistry. 1995;151(1):33–38. doi: 10.1007/BF01076893. [DOI] [PubMed] [Google Scholar]
- 22.Kwasniewska A., Tukendorf A., Semczuk M. Serum antioxidant concentrations in pregnancy induced hypertension. Med. Sci. Monit. 1998;4(3):44–44. [Google Scholar]
- 23.Brown K.M., Morrice P.C., Duthie G.G. Vitamin E supplementation supresses indexes of lipid peroxidation and platelet counts in blood of smokers and non-smokers but plasma lipoprotein concentrations remain unchanged. Am. J. Clin. Nutr. 1994;60:383–387. doi: 10.1093/ajcn/60.3.383. [DOI] [PubMed] [Google Scholar]
- 24.Gulmezoglu A.M., Hofmeyr G.J., Mathys M.J., Oosthuisen Antioxidants in the treatment of severe preeclampsia an explanatory randomized controlled triat. British Journal of Obstet. and Gynacol. 1997;104:689–696. doi: 10.1111/j.1471-0528.1997.tb11979.x. [DOI] [PubMed] [Google Scholar]
- 25.Eyal Schiff, Steven, Friedman A., Stampfer Meir, et al. Dietary consumption and plasma concentrations of vitamin E in pregnancies complicated by preeclampsia. Am. J. Obstet. Gynecol. 1996;175(4):1024–1028. doi: 10.1016/S0002-9378(96)80046-9. [DOI] [PubMed] [Google Scholar]
- 26.Wefers M., Sies H. The protection by ascorbate and glutathione against microsomal lipid peroxidation is dependent on vitamin E. Exp. J. Biochem. 1988;174:353–357. doi: 10.1111/j.1432-1033.1988.tb14105.x. [DOI] [PubMed] [Google Scholar]
- 27.Niki E., Yamamoto Y., Komuro E., Sato K. Membrane damage due to lipid oxidation. Am. J. Clin. Nutr. 1991;53:201–205. doi: 10.1093/ajcn/53.1.201S. [DOI] [PubMed] [Google Scholar]
- 28.Rao G.M., Sumita P., Roshrim M.N., Ashtagimatt Plasma antioxidant vitamins and lipid peroxidation products in pregnancy induced hypertension. India J. of Clin. Biochemistry. 2005;20(1):198–200. doi: 10.1007/BF02893070. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Frei B., England L., Ames B.N. Ascorbate is an outstanding antioxidant in human blood plasma. Proc. Natl. Acad. Sci. USA. 1989;86:6377–6381. doi: 10.1073/pnas.86.16.6377. [DOI] [PMC free article] [PubMed] [Google Scholar]