Preeklamptik Anne ve Bebeklerinde Asimetrik Dimetil Arjinin ve Oksidan/Antioksidan Düzeyi

Yıl 2023, , 112 - 119, 31.08.2023

Sedef Narin Tongal , İ.etem Pişkin , Cumhur Aydemir , İnan İlker Arıkan , Murat Can

https://doi.org/10.29058/mjwbs.1051152

Öz

Amaç: Preeklampsili gebelerde asimetrik dimetilarjinin (ADMA) düzeyinin sağlıklı gebelere göre anlamlı oranda yüksek olduğu,
ADMA yüksekliğinin preeklampsinin klinik işaretlerinden daha önce geliştiği ve ADMA’nın preeklampsinin patogenezinde rol oynadığı
düşünülmektedir. Bu çalışmada, sağlıklı ve preeklamptik gebeler ve bebeklerinden alınan serum ADMA, nitrik oksit metaboliti total nitrit
ve nitrat (NOx), arjinin ve total antioksidan kapasite (TAK) ve plasenta örneklerindeki düzeylerinin preeklampsi ile ilişkili olup olmadığı, bu
belirteçlerle preklampsinin önceden tespit edilip edilemeyeceği ve bunun sonucunda anne ve bebekte gelişebilecek olası sorunların önlenip
önlenemeyeceğinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Zonguldak Bülent Ecevit Üniversitesi Kadın Doğum Servisinde takip edilen 62 gebe ve bebeği çalışmaya alınarak
preeklampsisi olan 31 gebe ve bebeği Grup I, hasta grubunu; preeklamptik olmayan 31 gebe ve bebeği ise Grup II, kontrol grubunu
oluşturdu. Çalışmada değerlendirilmek üzere annelerden doğumdan önce, korddan doğum sırasında, bebeklerden doğumdan sonraki ilk
24 saat içinde kan örnekleri ve her gebeden plasenta örneği alındı. Preeklampsi tanısı olan ve olmayan annelerin yaşı, kilosu, ilk gebelik
durumu, gebelik süreleri, sistolik ve diastolik kan basıncı değerleri, bebeklerin ise doğum ağırlıkları, cinsiyetleri, tedavisi süresince gelişen
problem ve komplikasyonları, klinik ve laboratuar özellikleri, prognozları, ADMA, arjinin, NOx ve TAK düzeyleri incelendi.
Bulgular: İki grup karşılaştırıldığında prognozu etkileyebilecek antenatal faktörler açısından anlamlı fark yoktu. Preeklamptik anne grubunda
ADMA düzeyinin anlamlı olarak yüksek (p<0.001), arjinin değerinin anlamlı olarak düşük olduğu (p=0.001), NOx düzeyi ve TAK arasında ise
fark olmadığı saptandı. Kord kanı değerlendirildiğinde preeklamptik grupta ADMA düzeyinin anlamlı olarak yüksek (p=0.001), NOx değerinin
anlamlı olarak düşük olduğu (p=0.017), arjinin düzeyleri ve total antioksidan kapasite arasında fark olmadığı saptandı. Preeklamptik grup
plasentasında ADMA ve arjinin değerlerinin anlamlı olarak yüksek olduğu (p<0.001), total antioksidan kapasite düzeyinin düşük olduğu
görüldü (p=0.004). NOx değerinin iki grup arasında farklı olmadığı saptandı. Bebek kanları karşılaştırıldığında anne, kord kanı ve plasenta
örneklerinin aksine kontrol grubunda ADMA değerinin anlamlı yüksek olduğu (p=0.009), preeklamptik grupta arjininin anlamlı olarak yüksek
olduğu (p=0.041), iki grup arasında NOx ve TAK açısından fark olmadığı saptandı.
Sonuç: Bu çalışmada preeklamptik anne grubunda serum ADMA düzeyinin literatür ile uyumlu olarak arttığı saptandı. Çalışma literatürdeki
preeklamptik hastalarda nitrik oksit sentezinin azaldığı tezini desteklememektedir. Yüksek risk altındaki kadınların erken dönemde
belirlenmesinde ADMA yeni bir risk belirleyicisi olarak kullanılabilir.

Anahtar Kelimeler

Preeklampsi, asimetrik dimetilarjinin, total nitrit ve nitrat (NOx), arjinin, total antioksidan kapasite

Destekleyen Kurum

zonguldak bülent ecevit üniverstesi tıp fakültesi bap

Proje Numarası

2013/02-4

Teşekkür

Prof.Dr.İnan İlker Arıkan,Prof.Dr.Murat Can

Asymmetric Dimethyl Arginine and Oxidant/Antioxidant Level in Preeclamptic Mothers and Their Babies

Öz

Aim: It is thought that asymmetric dimethyl arginine(ADMA) level is significantly higher in pregnant
women with preeclampsia compared to healthy pregnant women, ADMA elevation develops before
the clinical signs of preeclampsia, and ADMA plays a role in the pathogenesis of preeclampsia. In this
study, it was aimed to investigate whether serum ADMA, total nitrite and nitrate (NOx), arginine and
total antioxidant capacity (TAC) and levels in placenta samples taken from healthy and preeclamptic
pregnant women and their babies are associated with preeclampsia, whether preeclampsia can be
detected beforehand with these markers, and whether possible problems that may develop in the
mother and baby can be prevented as a result.
Material and Methods: 62 pregnant women and their babies who were followed up in Zonguldak
Bülent Ecevit University obstetrics service are divided two groups; 31 preeclamptic pregnant and babies
(Group I), formed Patient group; 31 pregnant and babies without preeclampsia (Group II), formed
Control Group. Blood samples were obtained from mothers before birth, from the cord during birth, from
babies in first 24 hours after birth and placenta samples were obtained from each pregnant to evaluate
in the study. Age, weight, initial pregnancy state, pregnancy period, systolic and diastolic blood pressure
levels of mothers with and without pre-eclampsia diagnosis, while birth weights, genders, problems and
complications during treatment process, clinic and laboratory properties, prognosis, ADMA, arginine,
NOx and TAC levels of babies were examined in this study.
Results: There was no significant difference between two groups about antenatal factors that effect
on prognosis. In the comparison of blood values, ADMA level of preeclamptic group was significantly
higher (p<0.001) while arginine value was significantly lower (p=0.001) than control group, there was
no significant difference in NOx level and TAC between two groups. In the evaluation of cord ADMA
level of preeclamptic group was significantly higher (p=0.001) while nitric oxide value was significantly
lower (p=0.017) than control group and there was no significant difference in arginine and TAC. Values
which are studied in placenta samples showed that ADMA and arginine values were significantly high
(p<0.001) total antioxidant capacity level was low (p=0.004) in placenta of preeclamptic group. There
was no difference in NOx value of two groups. In the consideration of data of babies, mean pregnancy
weeks and genders were similar. Against the values of samples from mother, cord and placenta, when
baby blood was compared, ADMA value of control group was significantly high (p=0.009) while arginine
value of preeclamptic group was significantly high (p=0.041) and there was no difference between two
groups about their NOx and TAC.
Conclusion: In this study, it is determined that serum ADMA level of preeclamptic mother group increases in accordance with literature
values. This study does not support the decrease of nitric oxide synthesis thesis in preeclamptic patients as mentioned in literature. To
determine the women with the high risk in the early period, the asymmetric dimethyl arginine may be used as the new risk decisive.

Anahtar Kelimeler

Preeclampsia, asymmetric dimethyl arginine, total nitrite and nitrate (NOx), arginine, total antioxidant system

Proje Numarası

2013/02-4

Kaynakça

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