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

Yıl 2021, , 437 - 442, 30.09.2021

Sükeynet Aydın , Asuman Deveci Özkan , Hilal Uslu Yuvacı , Fatıma Betül Tuncer , Mehmet Akdoğan

https://doi.org/10.34087/cbusbed.841840

Öz

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

Anahtar Kelimeler

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

Destekleyen Kurum

Scientific Research Projects Foundation (BAP) of the Sakarya University of Turkey

Proje Numarası

2019-7-24-117

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

Proje Numarası

2019-7-24-117

Kaynakça

• Agarwai, I, Karumanchi, S.A, Preeclampsia and anti-angiogenic state, Pregnancy Hypertension, 2011, 1(1), 17-21.
• Aggarwal, R, Jain, A.K, Mittal, P, Kohli, M, Jawanjal, P, Rath, G, Association of pro-and anti-inflammatory cytokines in preeclampsia, Journal of clinical laboratory analysis., 2019, 33(4), e22834.
• Tahergorabi, Z, Khazaei, M, A review on angiogenesis and its assays, Iran Journal of Basic Medical Science, 2012, 15(6), 1110-1126.
• Tomimatsu, T, Mimura, K, Matsuzaki, S, Endo, M, Kumasawa, K, Kimura T, Preeclampsia: maternal systemic vascular disorder caused by generalized endothelial dysfunction due to placental antiangiogenic factors, International Journal of Molecular Science, 2019, 20(17), 4246.
• Collier, A.Y, Zsengeller, Z, Pernicone, E, Salahuddin, S, Khankin, E.V, Karumanchi, S.A, Placental sFLT1 is associated with complement activation and syncytiotrophoblast damage in preeclampsia, Hypertension in Pregnancy, 2019, 38(3), 193-199.
• Chang, X, Yao, J, He, Q, Liu, M, Duan, T, Wang, K, Exosomes from women with preeclampsia induced vascular dysfunction by delivering sFlt (Soluble Fms-Like Tyrosine Kinase)-1 and sEng (Soluble Endoglin) to endothelial cells, Hypertension, 2018, 72(6), 1381-1390.
• Tellioğlu, A, Başaran, S, Vitamin D in the light of current knowledge, Archive Medical Review Journal, 2013, 22(2):259-271.
• Neumaier, M, Braun, A, Wagener, C, Fundamentals of quality assessment of molecular amplification methods in clinical diagnostics. International Federation of Clinical Chemistry Scientific Division Committee on Molecular Biology Techniques, Clinical chemistry, 1998, 44(1), 12–26.
• Obi, Y, Hamano, T, Isaka, Y, Prevalence and prognostic implications of vitamin D deficiency in chronic kidney disease, Disease Markers, 2015, 1-9.
• Erbay, E, Mersin, S, İbrahimoğlu, Ö, Vitamin D and its effect on body systems, Journal of Health Scholars, 2019, 6(3), 201-206.
• Walentowicz-Sadlecka, M, Domaracki, P, Sadlecki, P, Siodmiak, J, Grabiec, M, Walentowicz, P, Moliz, M.T.A, Odrowaz-Sypniewska G, Assesment of the sFlt-1 and sFlt-1/25(OH)D ratio as a diagnostic tool in gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM), Disease Markers, 2019, 5870239.
• Li, Y, Lin, Y, Tumor necrosis factor alpha-308G/A polymorphism and the risk of multiple myeloma: a meta- analysis of pooled data from twelve case- control studies, Turkish Journal of Hematology, 2019, 36(2), 72-80.
• Decout, B, Lahiri, K.D, Sabbagh M.N, Targeting tumor necrosis factor alpha for alzheimer’s disease, Current Alzheimer Research, 2017, 14(4), 412-425.
• Aydın, V, Akıcı, A, Infections due to TNF-alpha inhibitor use in rheumatological diseases, The Journal of Turkish Family Physician, 2018, 9(1), 13-24.
• Yockey, L.J, Iwasaki, A, Role of interferons and cytokines in pregnancy and fetal development, Immunity, 2018, 49(3), 397-412.
• Mawardi, S, Ganie, R.A, Lumbanraja, S.N, Levels of interleukın-6 and tumor necrosis factor alpha in pregnant patients with preeclampsia and patients with normal pregnancy, Indonesian J of Clınıcal Pathology and Medical Laboratory, 2019, 25(2), 199-201.
• Mangogna, A, Agostinis, C, Ricci, G, Romano, F, Bulla, R, Overview of procalcitonin in pregnancy and in pre-eclampsia, Clinical and experimental immunology, 2019, 198(1), 37–46.
• Poon, L, Sahota, D, Screening and prevention of preeclampsia, Maternal-Fetal Medicine, 2019, 1(1), 25-30.
• Bodnar, L.M, Catov, J.M, Simnah, H.N, Holick, M.F, Powers, R.W, Roberts, J.M, Maternal vitamin D deficiency increases the risk of preeclampsia, The Journal of Clinical Endocrinology and Metabolism, 2007, 92(9), 3517-3522.
• Evans, K.N, Bulmer, J.N, Kilby, M.D, Hewison, M, Vitamin D and placental decidual function, Journal of the Society for Gynecologic Investigation, 2004, 11, 263-271.
• Chen, X, Xi, X, Cui, F, Wen, M, Hong, A, Hu, Z, Ni, J, Abnormal expression and clinical significance of 25- hydroxyvitamin D and sFlt-1 in patients with preeclampsia, Journal of International Medical Research, 2019, 47(10), 4673-4682.
• Udenze, I, Amadi, C, Awolola, N, Makwe, C.C, The role of cytokines as inflammatory mediators in preeclampsia, The Pan African Medical Journal, 2015, 20, 219.
• Chau, K, Hennessy, A, Makris, A, Placental growth factor and pre-eclampsia, Journal of Human Hypertension, 2017, 31(12): 782-786.
• Shokry, M, Bedaiwy, M.A, Fathalla, M.M, Alsemary, A, Elwakil, S, Murphy, A, Maternal serum placental growth factor and soluble fms-like tyrosine kinase 1 as early predictors of preeclampsia, Acta Obstetricia et Gynecologica Scandinavica, 2010, 89(1), 143-6.
• Mangogna, A, Agostinis, C, Ricci, G, Romano, F, Bulla, R, Overview of procalcitonin in pregnancy and in pre-eclampsia, Clinical and Experimental Immunology, 2019, 198, 37-46.
• Ülkumen, B.A, Güvenç, Y, Göker, A, Gözükara C, The relationship between neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin levels with the presence and severity of preeclampsia, The Journal of Maternal-Fetal & Neonatal Medicine, 2015, 28(16), 895-90.
• Dacaj, R, Izetbegovic, S, Stojkanvic, G, Dreshaj, S, Elevated liver enzymes in cases of preeclampsia and intrauterine growth restriction, Medical Archives, 2016, 70(1), 44-47.
• Gezer, C, Ekin, A, Ertas, I.E, Ozeren, M, Solmaz, U, Mat, E, Taner, C.E, High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia, Ginekologia Polska, 2016, 87(6), 431-5.
• Hajian-Tilaki, K, Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation, Caspian Journal of Internal Medicine, 2013, 4(2), 627–635.