Markers of obesity and growth in preeclamptic and normotensive pregnant women.

The objective of the study was to analyse leptin, IGF-1, Apo A, lipoproteins, haem oxygenase-1 (HO-1) in maternal sera and venous umbilical cord sera of newborn babies of 25 preeclamptics (group II), and 25 normotensive pregnant women (group I) as markers of obesity and growth in preeclamptic and normotensive pregnant women. Apo A I and II levels were estimated by competitive immunoassay using direct chemiluminiscence technology. Haem oxygenase-1 (HO-1), leptin and IGF-1 were analysed by ELISA. Maternal and cord blood levels of homocysteine, folic acid, lipid profile (namely, total cholesterol, triglycerides, LDL-C, VLDL-C and HDL-C), Haem oxygenase 1 were higher in preeclamptic women as compared to normotensive pregnant women. Serum and cord blood Apo A-I and Apo B, leptin levels, IGF-I were lower in preeclamptic women as compared to normotensive pregnant. The findings of high serum HO-1 levels in maternal and cord blood in preeclampsia supports the role of oxidative stress and excessive inflammatory response in the pathogenesis of preeclampsia. It seems likely that IGF-1 and leptin play a central role in controlling foetal growth. There is increasing evidence that the foundations of life-long health are, in part, laid in the uterus. Findings of present study suggest that alterations in biochemical markers of growth and obesity occur in mothers and foetuses and modifications of uterine environment can be of help to prevent future cardiovascular risk. Impact statement Preeclampsia has been reported to be associated with an increased risk of later life cardiovascular disease. However, information regarding how obesity increases the risk of preeclampsia is limited. Atherogenic milieu occurring during pregnancy persists into adulthood and foetal growth retardation is strongly associated with adult atherosclerosis. There is conflicting evidence regarding alterations of IGFs in preeclamptic pregnancies and deficit in circulating and cord blood IGF-1 levels in intrauterine growth restricted newborns and a correlation between IGF-1 levels and birth weight have been reported. Leptin is a predictor of cardiovascular risk independent of insulin resistance. Emerging evidence supports an important role for the haem oxygenase system (HO-1) in the maintenance of a healthy pregnancy, especially during pathological challenge. Conflicting data are available regarding HO-1, leptin and IGF -1 in preeclamptic mothers. The extent to which they mediate foetal growth and developmental abnormalities remains to be clarified. Serum IGF-1 levels were significantly decreased in preeclamptics and maternal IGF-1 showed a strong inverse correlation with leptin levels. High serum HO-1 levels in maternal and cord blood in preeclampsia were observed in the present study. Findings of the present study suggest that alterations in biochemical markers of growth and obesity occur in mothers and foetuses and modifications of the uterine environment can be of help to prevent future cardiovascular risk.

Patterns of Biomarkers in Cord Blood During Pregnancy and Preeclampsia.

BACKGROUND: Umbilical cord blood (UCB) is in contact with all the fetal tissues and can reflect the state of fetus and UCB can be compared with maternal blood. Inflammatory, metabolic and immunological disorders during pregnancy can affect the environment in which the fetus is developing and may produce various alterations. OBJECTIVE: To analyze different biochemical parameters in maternal venous blood and new born umbilical cord blood from healthy normotensive pregnant and preeclamptic women. MATERIALS AND METHODS: Homocysteine, folate, B12, heme oxygenase-1 (HO-1), endoglin, leptin, cholinesterase, IGF-1, Apo A, lipoproteins, TSH, fT3, fT4 were analyzed in maternal sera and venous umbilical cord sera of newborns of twenty five preeclamptics (group II) and twenty five normotensive pregnant women (group I). Homocysteine, folic acid, vitamin B12, Apo A I & II, TSH, fT3, fT4 levels were estimated by competitive immunoassay using direct chemiluminiscence technology. Heme oxygenase-1 (HO-1), endoglin, leptin, cholinesterase, IGF-1 were analyzed by ELISA. RESULTS: Maternal and cord blood levels of homocysteine, folic acid, lipid profile (namely, total cholesterol, triglycerides, LDL-C, VLDL-C and HDL-C), TSH, heme oxygenase 1, were higher in preeclamptic women as compared to normotensive pregnant women. Endoglin levels were significantly lower in cord blood of preeclamptic mother as compared to normotensive mothers. Serum and cord blood vitamin B12, Apo A-I and Apo B l, cholinesterase, leptin levels, IGF-I were lower in preeclamptic women as compared to normotensive pregnant. CONCLUSION: Findings of the present study suggest that biochemical alterations occur in mothers and fetuses and modifications of uterine environment (in terms of thyroxine and folate and vitamin B12 supplementation) can be of help.

Correlation of thyroid functions with severity and outcome of pregnancy.

BACKGROUND: During normal pregnancy, changes in thyroid function are well documented; however, information regarding thyroid function in preeclampsia is scanty. AIM: The present study was planned to study thyroid hormones in mild and severe preeclamptic women and normotensive women and correlate them with outcome of pregnancy. SUBJECT AND METHODS: Thyroid hormones were analyzed in mild (n = 50) and severe (n = 50) cases of preeclamptic women and normotensive women (n = 100). RESULTS: Thyroid-stimulating hormone (TSH) and TT4 levels were higher in mild preeclampsia as compared with severe preeclampsia (P < 0.001 and P < 0.01, respectively). TT3 levels were lower in preeclampsia (more so in severe preeclamptics as compared with normotensive pregnant and non-pregnant women). Preeclamptic with raised TSH levels had significantly higher mean arterial blood pressure and low birth weight (BW). A negative correlation was observed between BW and TSH levels (r = 0.296, P < 0.001) and BW and TT4 levels. A positive correlation was observed between BW and TT3 levels. CONCLUSION: These findings indicate that there is a state of biochemical hypothyroidism that correlates with severity of preeclampsia and influences obstetric outcome in these women. Identification of thyroid hormone in pregnancy might be of help in predicting occurrence of preeclampsia.

Serum fluoride and sialic acid levels in osteosarcoma.

Osteosarcoma is a rare malignant bone tumor most commonly occurring in children and young adults presenting with painful swelling. Various etiological factors for osteosarcoma are ionizing radiation, family history of bone disorders and cancer, chemicals (fluoride, beryllium, and vinyl chloride), and viruses. Status of fluoride levels in serum of osteosarcoma is still not clear. Recent reports have indicated that there is a link between fluoride exposure and osteosarcoma. Glycoproteins and glycosaminoglycans are an integral part of bone and prolonged exposure to fluoride for long duration has been shown to cause degradation of collagen and ground substance in bones. The present study was planned to analyze serum fluoride, sialic acid, calcium, phosphorus, and alkaline phosphatase levels in 25 patients of osteosarcoma and age- and sex-matched subjects with bone-forming tumours other than osteosarcoma and musculo-skeletal pain (controls, 25 each). Fluoride levels were analyzed by ISE and sialic acid was analyzed by Warren's method. Mean serum fluoride concentration was found to be significantly higher in patients with osteosarcoma as compared to the other two groups. The mean value of flouride in patients with other bone-forming tumors was approximately 50% of the group of osteosarcoma; however, it was significantly higher when compared with patients of group I. Serum sialic acid concentration was found to be significantly raised in patients with osteosarcoma as well as in the group with other bone-forming tumors as compared to the group of controls. There was, however, no significant difference in the group of patients of osteosarcoma when compared with group of patients with other bone-forming tumors. These results showing higher level of fluoride with osteosarcoma compared to others suggesting a role of fluoride in the disease.

Diagnostic value of sialic acid in pleural effusion.

The present study was conducted in 30 patients of malignant pleural effusion and 30 patients of non malignant pleural effusion. Pleural fluid and blood samples were taken at the time of admission, before starting any treatment. Sialic acid levels were estimated in serum and pleural fluid by Warren's TBA method. In the present study, serum sialic acid levels were higher in group II as compared to group I. In the present study, pleural fluid sialic acid levels and PF/S ratio was higher in malignant pleural effusion (though difference was not statistically significant). Smokers in group II had higher serum sialic acid as compared to group 1 (P < 0.05). The sensitivity and specificity of pleural fluid/serum sialic acid ratio with cut off value of 0.7 were 76.67% and 20% respectively, while taking the cut off value of 70 mg/dL for pleural fluid sialic acid in malignant pleural effusions, the sensitivity was 63.33%, specificity 60% and positive predictive value 46.34%. These findings indicate that determination of sialic acid levels in pleural fluid has diagnostic value as a cheap, simple and reliable marker for malignant pleural effusion.

Plasma concentrations of lipid peroxidation products in children with acute leukaemia.

Acute leukaemia is the most common childhood malignancy. The cause of leukaemia is not known in most of the cases and of late free radicals have been implicated in the pathogenesis of leukaemia. The degree of lipid peroxidation was studied in the present study as a marker of disease activity in 15 patients of acute lymphoblastic leukaemia and 20 healthy age and sex matched individuals served as control. Serum malonaldehyde (MDA) levels were increased in leukaemia and were higher in the active phase of disease as compared to those in remission, Hence, serum MDA estimation in leukaemia can be of help in diagnosis and to predict the chances of relapse.

Effect of smoking on lipid profile, lipid peroxidation and antioxidant status in normal subjects and in patients during and after acute myocardial infarction.

We studied changes in lipid peroxidation, vitamin E status and lipid profile due to smoking in healthy subjects, patients with acute myocardial infarction (MI), and in stabilized patients surviving MI. A significant increase in malondialdehyde (MDA) concentrations was observed in MI patients, more than in smokers (P<0.05), as compared to control. The plasma vitamin E as well as the ratio of vitamin E/lipids were significantly lower in MI patients as compared to stable ischemic heart disease (IHD) patients and controls. Our data show that smoking is associated with lowered antioxidant status in MI.

Vitamin E and C in preeclampsia.

Vascular endothelial damage has been implicated in the pathophysiology of preeclampsia. Lipid peroxidation may be involved in the process and essential nutrients that can scavenge free radicals, such as vitamin E and C, operate in concert. Antioxidant vitamins E and C were estimated in 30 preeclamptic and 30 normotensive pregnant women. Significantly lowered levels of vitamins E and C were observed in preeclamptic women as compared to controls (P<0.001 and P<0.05 respectively). In patients with preeclampsia antioxidant nutrients may be utilized to a greater extent to counteract free radical-mediated cell disturbances, resulting in a reduction in serum antioxidant levels.

Lipid peroxidation in pregnancy with preeclampsia and diabetes.

We studied lipid peroxidation and vitamin E levels in 12 diabetic preeclamptic, 13 nondiabetic preeclamptic, 8 gestational diabetic, 25 normotensive pregnant women, and 25 healthy nonpregnant women. A significant increase in malonaldehyde (MDA) levels was observed in preeclamptic and diabetic preeclamptic women as compared to normotensive pregnant and healthy controls (p<0.001). An increase in MDA levels was observed in gestational diabetics, but the difference was not statistically significant. Likewise, a significant fall in vitamin E levels was noted in preeclamptic and diabetic preeclamptic groups as compared to controls (p<0.001). Gestational diabetics had a slight decrease in vitamin E levels relative to controls. These findings suggest that lipid peroxidation plays a role in the pathogenesis of preeclampsia.

Altered thiol status in preeclampsia.

Thirty preeclamptic, 30 normotensive pregnant and 25 healthy nonpregnant women were analyzed with regard to the antioxidant system (thiols and superoxide dismutase, SOD). In preeclampsia both plasma and lysate thiol levels were significantly lower compared to controls (p < 0.001). SOD levels were higher in normotensive pregnant women, but were lower in preeclamptic compared to nonpregnant women. This finding of antioxidant changes in the red blood cell suggests that red cell dysfunction is fundamental in the development of preeclampsia, and similar alterations in the balance of the thiol could be present across the endothelial cell membrane.

Effect of glycemic control and vitamin E supplementation on total glutathione content in non-insulin-dependent diabetes mellitus.

Thirty patients with non-insulin-dependent diabetes mellitus were selected for the study. 15 age-matched healthy volunteers served as controls. Serum malonaldehyde, total glutathione, and vitamin E levels were estimated before and after glycemic control and after 4 weeks of vitamin E supplementation. Both total glutathione and vitamin E levels increased after glycemic control and showed an increase after vitamin E supplementation. Malonaldehyde levels lowered after glycemic control, but remained higher than controls. Since vitamin E supplementation significantly decreased oxidative stress in the present study, it may play a role in reducing free-radical-induced oxidant injury in diabetes mellitus.

Total free radical trapping antioxidant potential in pre-eclampsia.

OBJECTIVE: The aim of the present study was to measure serum urate, tocopherol and ascorbate and to calculate total radical trapping antioxidant potential (TRAP) in pre-eclampsia. METHODS: Study samples were taken from 25 pre-eclamptic, 25 normotensive pregnant and 25 non-pregnant healthy females for measuring uric acid, vitamin C and E, total sulfhydryl group. Also lipid peroxidation product malonaldehyde (MDA), the superoxide generation (NBT reduction) were estimated and TRAP was calculated. Data were analyzed statistically using Student's t-test. RESULT: Pre-eclamptic women had significantly increased MDA levels, superoxide generation and uric acid levels as compared to control subjects (P<0.001). Vitamin C and E and total thiols were lower in pre-eclampsia as compared to control subjects (P<0.001). TRAP was significantly higher in pre-eclampsia. CONCLUSION: TRAP provides a means of assessing the total capacity of the chain-breaking antioxidants to prevent lipid peroxidation in plasma.

Low whole blood glutathione levels in pregnancies complicated by preeclampsia and diabetes.

Nineteen pregnancies with preeclampsia, 16 with diabetic preeclampsia and 29 control pregnancies were analyzed with regards to maternal total glutathione. In preeclampsia, maternal total glutathione levels were lower than in normal pregnancy (P<0.001). Also, diabetic preeclamptics showed low total glutathione levels as compared to preeclampsia (P<0.05) and control (P<0.001). These findings indicate decreased detoxificating or free radical scavenging capacity in pregnancies complicated by preeclampsia and diabetes.

Evaluation of oxidative stress before and after control of glycemia and after vitamin E supplementation in diabetic patients.

The present study evaluates the presence of oxidative stress in the uncontrolled diabetic state. Glycemic control reduced the oxidative stress, but total normalization of the parameters of oxidative stress was not achieved, indicating continued oxidant injury despite optimal control of the diabetes. Vitamin E supplementation for 4 weeks in these patients further reduced the oxidative stress, suggesting that vitamin E supplementation might be helpful in reducing free-radical-induced oxidant injury.

Superoxide anion formation and glutathione levels in patients with preeclampsia.

Increased free radical activity has been implicated in the pathogenesis of preeclampsia. This article investigates the glutathione status in preeclampsia and whether superoxide generation is enhanced in preeclampsia. Venous blood samples were obtained from 30 preeclamptic women and 30 normotensive pregnant women (controls). Superoxide generation and glutathione content were measured. There was a significant increase in superoxide generation and a marked reduction in glutathione content in preeclamptic women as compared to controls (p < 0.001). These results indicate that enhanced superoxide generation and impaired glutathione metabolism may be involved in the pathogenesis of preeclampsia.

Role of oxygen free radicals in shock.

AIMS OF THE STUDY: To study lipid peroxidation, magnesium levels (Mg) in plasma and red cells (RBC), superoxide dismutase (SOD) and catalase (CAT) activities in the plasma and RBC of shock patients. METHODOLOGY: Twenty five patients with clinically defined septic shock and 30 healthy volunteers were selected for the study to study the parameters of oxidative stress. RESULTS: Septic shock patients had higher activities of plasma and RBC SOD and CAT activities as compared to control. Also, plasma Mg and malonaldehyde (MDA) levels were higher in shock patients as compared to controls. While, RBC Mg levels were similar in two groups. CONCLUSIONS: The finding of increased concentration of MDA, Mg, SOD and CAT in sepsis implicates oxygen free radicals in the pathophysiology and free radical scavengers may have a role in organ preservation.

Magnesium deficiency potentiates free radical production associated with myocardial infarction.

OBJECTIVE: Oxidative injury and magnesium deficiency may accompany cardiovascular disease states and the study was planned to find out whether magnesium deficiency promotes oxidative injury. METHODS: Serum malonaldehyde (MDA), magnesium, vitamin E and total glutathione levels (GSH) were estimated in 22 patients with acute myocardial infarction and 15 healthy controls. RESULTS: Low levels of Mg, GSH, vitamin E and elevated levels of MDA were observed in patients of acute myocardial infarction. Statistically significant correlations were observed between Mg and MDA, MDA and GSH, Mg and vitamin E. CONCLUSION: Our findings suggest that Mg deficiency can potentiate oxidative injury to post ischaemic myocardium and that antioxidants may have a role in protection against the prooxidant influence(s) of Mg deficiency.