Interleukin-6 and its correlations with maternal characteristics and echocardiographic parameters in pre-eclampsia, gestational hypertension and normotensive pregnancy.

BACKGROUND: Pre-eclampsia and gestational hypertension are pregnancy-related disorders with major maternal cardiovascular implications later in life. OBJECTIVES: The aim of this study was to determine interleukin-6 levels in women with pre-eclampsia and gestational hypertension and in healthy pregnant controls, and to examine their correlations with characteristics of the women and echocardiographic findings. METHODS: The ELISA method was used to determine serum interleukin-6 in 36 women with gestational hypertension, 37 women with pre-eclampsia and 50 pregnant controls. The echocardiographic examination was performed according to current recommendations by the European Association of Cardiovascular Imaging and the American Society of Echocardiography. RESULTS: Mean serum interleukin-6 levels were 2.77 pg/ml in the controls, 5.08 pg/ml in the gestational hypertension group and 8.06 pg/ml in the pre-eclampsia group. A significant difference in these levels was present between the controls and both hypertensive groups, but not between the two hypertensive groups. Higher levels correlated with heart chamber enlargement and worse ventricular function. CONCLUSION: Interleukin-6 levels in gestational hypertension and pre-eclampsia were significantly elevated compared to those in healthy pregnancy. Higher levels also corresponded to echocardiographical changes.

High-sensitivity CRP levels in women with gestational hypertension, preeclampsia and in normotensive pregnant women and its correlations.

INTRODUCTION: Gestational hypertension is a less investigated hypertensive disorder of pregnancy than preeclampsia, but evidence exists of an unfavourable cardiovascular profile for women after such a pregnancy. AIM: To determine serum high-sensitivity C-reactive protein (hs-CRP) levels in women with preeclampsia, gestational hypertension, and in normotensive pregnancy in order to assess the cardiovascular implications and to examine its correlations with some characteristics of women. MATERIALS AND METHODS: Thirty-six women with gestational hypertension, thirty-seven with preeclampsia, and fifty maternal and gestational age-matched controls were included in a single-center prospective clinical-epidemiological study. Serum hs-CRP levels were determined using ELISA method. RESULTS: Significantly higher hs-CRP levels were found in the gestational hypertension group than in the controls (p=0.043), but not in the preeclampsia group (p=0.445). The levels between the two pathological groups did not differ significantly (p=0.247). Odds ratio for hs-CRP levels higher than the provided cut-off was 3.31 (95% CI 1.32-8.29) for the presence of gestational hypertension. In the normotensive pregnant women, the hs-CRP levels had a positive correlation with BSA, pre-pregnancy and current BMI, but such correlations were absent in the hypertensive groups. There were no correlations with the maternal or gestational age, current weight gain in any of the groups or with the highest detected blood pressure in the pathological groups. These levels did not differ according to gravidity, smoking status and smoking during pregnancy. CONCLUSIONS: Elevation of hs-CRP was more pronounced in women with gestational hypertension than in women with preeclampsia, which could indicate a different pathophysiological mechanism and a higher cardiovascular risk for those women.

Reference Values of Certain Serum Indicators of Liver Fibrosis.

BACKGROUND: Liver fibrosis shows a continuously increasing trend worldwide, due to alcohol abuse, obesity, and, to a lesser extent, chronic hepatitis B and C. Biopsy is still considered the "gold standard" for diagnosis of liver fibrosis. However, it has a number of limitations, such as invasiveness, high cost, need for specialists to conduct and interpret biopsy results, risk of complications, inability to dynamically monitor the pathological process, low patient compliance, and uneven fibrosis distribution. Therefore, there is an increasing demand for non-invasive serum markers that are characterized by easy implementation, low cost, possible repeatability, and high patient compliance. METHODS: For a period of two years, 82 clinically healthy, middle aged subjects, mean age 40.5 ± 12.37 years, range 21 - 67 years, were studied. The group was tested for platelet count, prothrombin time, and the following biochemical parameters: Cholesterol - total, HDL, LDL; AST; ALT; GGT; total bilirubin, alfa-2-macroglobulin; haptoglobin and ELF (Enhanced Liver Fibrosis). RESULTS: Reference values of a large number of serum indicators of liver fibrosis are disputable and unspecified. A direct proportional and moderate correlation was found between the BMI and AST, ALT, INR, APRI, GPRI, and Forns Index. CONCLUSIONS: We present our original reference values for ELF, AST/ALT, ARPI, GRPI, Fib 4, and Forns Index in 82 clinically healthy subjects.

Albuminuria and Glomerular Filtration in Patients with Essential Hypertension.

BACKGROUND: Essential hypertension (EH) is a widespread disease. One frequent complication of EH is Chronic Kidney Disease (CKD), whose diagnosis is delayed due to its asymptomatic course. The purpose of this study is to determine the involvement of the kidneys in patients with EH by biomarkers for kidney damage (albuminuria) and glomerular filtration rate (GFR) with creatinine and cystatin C. METHODS: We observed a control group of 153 healthy volunteers and a group of 150 patients with EH. The biomarkers we tested were urinary albumin, ACR, total protein, and PCR. The GFR was calculated by the CKD-EPI formula using creatinine simultaneously and by the combined formula CKD-EPI using creatinine and cystatin C. RESULTS: The obtained results for the studied biomarkers in the control group are similar to the ones reported in the literature. In the group of patients with EH (at the time of study none of which had been diagnosed with CKD) we observed albuminuria A2 in 59 of the patients (39.9%) and none with albuminuria A3; increased ACR in 60 patients (40%); PCR above reference range in 42 patients (28%). GFRR was < 60 mL/min/1.73 m2 in 13 patients (8.6%). CONCLUSIONS: These results show that albuminuria A2 and ACR are sensitive, while GFR is a specific biomarker for kidney damage. For patients with EH, a timely follow-up of these biomarkers is necessary in order to decrease the progression of the kidney damage to Chronic Kidney Failure, cardiac complications, and premature mortality.