D Vitamini ve Anjiopoetik Faktörlerin Preeklampside Değerlendirilmesi

Öz

Giriş ve Amaç: Patogenezi halen tam olarak aydınlatılmamış bir gebelik komplikasyonu olan preeklampsi, gelişmiş ülkelerde maternal/fetal morbidite ve mortalitesi yüksek seyreden hastalıklar arasındadır. Literatürde D vitamini eksikliğinin gebe kadınlarda daha sık görüldüğü ve preeklampsili gebelerde D vitamini eksikliğinin değerlendirildiği çalışmaların çelişkili sonuçlara sahip olduğu görülmektedir. Bu çelişkiler göz önünde bulundurularak çalışmamızda preeklampsi ile komplike olmuş gebelerde maternal eksikliği/yetersizliğinde birçok rahatsızlığa sebep olan D Vitamini ve anjiopoetik faktörlerin düzeyinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi (SEAH) Kadın Hastalıkları ve Doğum Polikliniği’ne başvuran 31 preeklampsi tanısı almış gebe ve 32 sağlıklı gebe dahil edilmiştir. Hasta ve kontrol grubundaki bireylerden alınan açlık kan numuneleri santrifüj edilip serum ve plazmalarına ayrılmıştır. Serum 25(OH)Vitamin D düzeyi CLIA yöntemiyle, TNF-α ve PIGF düzeyi ELISA yöntemiyle, PCT düzeyi ise ECLIA yöntemiyle ölçülmüştür. Bulgular: Preeklamptik gebe grubunda 25(OH)Vitamin D ve PIGF düzeyi kontrol grubuna göre düşük (p<0,001), TNF-α ve PCT düzeyleri ise yüksek tespit edilmiştir (p<0,001), (p<0,05). TNF-α düzeyi ve AST, ALT değerleri arasında istatistiksel olarak anlamlı pozitif bir korelasyon bulunmuştur (p=0,001). Ayrıca PCT düzeyi ve PLT sayısı arasında da anlamlı pozitif bir korelasyon ortaya konmuştur (p=0,000). Sonuç: Çalışmamızın sonuçları preeklamptik gebelerde serum 25(OH)Vitamin D düzeylerinin sağlıklı gebelere göre düşük olduğunu ve bir inflamasyon belirteci olan TNF-α düzeylerinin de yüksek olduğunu göstermektedir.

Anahtar Kelimeler

• Preeklampsi
• D Vitamini
• Tümör Nekrozis Faktör Alfa
• Plasental Büyüme Faktörü
• Prokalsitonin

Evaluation of the Level of Vitamin D and Angiopoetic Factors in Preeclampsia

Abstract

Objective: Preeclampsia (PE), a pregnancy complication whose pathogenesis is still not fully clarified. Studies in the literature evaluating vitamin D deficiency more frequently in women with PE have conflicting results. Considering these contradictions, we aimed to evaluate the level and predictable potential of Vitamin D and angiogenic factors causing many disorders in maternal deficiency/insufficiency in women with PE. Materials and Methods: Thirty-one (31) women diagnosed with PE and thirty-two (32) healthy pregnant women were included in this study. Vitamin D levels were measured by the chemiluminescence immunoassay (CLIA) TNF-α and PLGF levels by ELISA and PCT levels by electrochemiluminescence assay (ECLIA) method. ROC curves were created to determine the role of biochemical parameters in the prediction of PE. Results: Vitamin D and PLGF levels were found lower and TNF-α and PCT levels were found higher in the PE group compared to the control group. The area under the ROC was 0.814, 0.7681, 0.8201, 0.9251 for gestational week (GW), Vitamin D, TNF-α and PLGF, respectively. Conclusion: Vitamin D, TNF-a, PLGF values are consistent with the literature and they could be important markers in the prediction of PE. Our data revealed that these markers, which are already routinely analyzed, do not require an additional cost and time. Thereby, women with PE could be identified and followed up closely

Keywords

• Preeclampsia
• vitamin D
• PrTumor Necrosis Factor Alpha
• Placental Growth Factor
• Procalcitonin

Kaynakça

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