Journal
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
Volume 282, Issue 4, Pages 371-375Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00404-009-1234-6
Keywords
Preeclampsia; Homocysteine; Asymmetric dimethylarginine; Nitric oxide
Categories
Funding
- Heilongjiang Province Natural Science Foundation of China [D200532]
- Heilongjiang Science and Technology Agency, Harbin, China
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Purpose Endothelial dysfunction underlies the pathogenesis of preeclampsia, but its mechanism has not yet been completely understood. In this study we have aimed to measure homocysteine (Hcy), asymmetric dimethylarginine (ADMA), and nitric oxide (NO) levels as endothelial dysfunction markers in preeclamptic women. Methods Control-case study with 62 preeclamptic patients and 30 controls without pregnancy complications was conducted. Plasma total Hcy, determined by capillary column gas chromatography/mass spectrometry (GC/MS), was correlated with serum ADMA (determined by liquid chromatography/tandem mass spectrometry using (13)C(6)-L-arginine as the internal standard) and NO (analyzed by GC/MS). Results There was a highly significant increase in the plasma concentration of homocysteine (P < 0.001) and ADMA (P < 0.001) and a highly significant decrease in the plasma concentration of nitric oxide (P < 0.001) among the preeclamptic patients. The differences were more significant between mild and severe preeclampsia, with and without eclampsia, with and without HELLP (hemolysis, elevated serum level of liver enzymes, and low platelets). In the combined patients and control groups a highly significant positive correlation was found between the plasma concentrations of homocysteine and ADMA (r = 0.853, P < 0.001). In addition, significant negative correlations were detected between the plasma concentrations of nitric oxide and the plasma concentration of homocysteine (r = -0.870, P < 0.001) and ADMA (r = -0.895, P < 0.001). These significant correlations were found to persist, even when they were restricted to the preeclamptic patients. Conclusions The homocysteine ADMA NO may be at least partly responsible for etiology in preeclampsia and could be regarded as markers for the severity of the disease. Therefore, L-arginine may represent a novel therapy for the treatment of preeclampsia.
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