Correlation Of Adiponectin And Endothelin-1 In Hypertensive Disorder Complicating Pregnancy

Backgrounds and ObjectiveHypertensive disorder complicating pregnancy is a pregnancy-specific diseases. But so far the pathogenesis is clear. The current accepted mechanism is endothelial cell activation and damage theories.Adiponectin (APN) is a new protein which secreted by specific fat cells. It is not only involved in lipid metabolism, but aslo antagonizes the inflammatory injury of vascular endothelial cell function.Endothelin-1(ET-1) has a powerful vasoconstrictor. Related laboratory studies show that ET-1 might play an important role in physiological characteristics of fat cells. APN is a newly hormone protein and its research in the field of obstetrics and gynecology is still in its infancy. There was no joint report of APN and ET-1 related to HDCP at home or abroad.Through measuring and analyzing the expression level of serum APN and plasma ET-1 in normal nonpregnant women, and normal pregnant women, and patients with hypertensive disorder complicating pragnancy, we investigate the significance of the expression change and correlation of serum APN and plasma ET-1 between normal pregnancy and patients with hypertensive disorder complicating pregnancy. Materials and Methods1. Experimental groups124 cases were chosen from the Second Affiliated Hosptial of Zhengzhou University from January,2008 to August,2009. They were divided into three groups: Normal nonpregnant group:24 cases were from the healthy-adult women who did physical examination in our hospital.Normal pregnant group:30 cases were randomly selected from normal pregnancy (all cases are single fetus primipara). HDCP group: 70 cases were divided into two groups, including 36 cases of gestational hypertension and 34 cases of preeclamosia (all cases are single fetus primipara).Three groups were excluded family history and no history of recent infection.2. MethodsDouble-antibody sandwich enzyme-linked immunosorbent assay was used to assay the content of adiponectin in serum and endothelin-1 in plasma. Statistical analysis software SPSS13.0 was used to analyze experimental data and clinical data. Pearson correlation analysis tests was used to analyze the correlation between the expression level of adiponectin in serum and endothelin-1 in plasma (a=0.05 was the significance level).Results1. The expression levels of adiponectin in serum from normal pregnant group was significantly higher than those of normal nonpregnant group (P<0.05).2. The expression levels of adiponectin in serum from patients with hypertensive disorder complication pragnancy was significantly lower than those of normal pregnant group (P<0.05).3. The expression levels of adiponectin in serum existed significantly differences between gestational hypertension and preeclampsia group (P<0.05). This result showed a gradual downward trend with the disease progression.4. The expression levels of endothelin-1 in plasma from normal pregnant group was significantly higher than those of normal nonpregnant group (P<0.05).5. The expression levels of endothelin-1 in plasma from patients with hypertensive disorder complication pragnancy was significantly higher than those of normal controls (P<0.05). 6. The expression levels of endothelin-1 in plasma existed significantly difference between gestational hypertension and preeclampsia group (P<0.05).This result showed a gradual upward trend with the disease progression.7. Maternal plasma levels of ET-1 levels and serum level of APN existed negative correlation in HDCP group, but there existed no correlation in normal pregnant group. The following is the correlation coefficient of each group:normal late-pregnancy group(r=0.261,P>0.05); gestational hypertension group(r=-0.65, P<0.01), pre-eclamp sia group (r=-0.61, P<0.01).8. Among patients with pre-eclampsia, APN expression levels and mean arterial pressure (MAP) existed a negative correlation, but there existed a negative correlation between APN expression levels and birth weight (BW). Plasma ET-1 expression level and mean arterial pressure (MAP), urine protein existed a positive correlation, in addition, plasma ET-1 expression level and birth weight (BW) existed a negative correlation.Conclusion1. APN and ET-1 might play a role in the normal pregnant process.2. APN and ET-1 might be closely related to the onset and progression in HDCP, especially in pree-clampsia.3. The expression levels of serum adiponectin and plasma endothelin-1 from patients with pre-eclampsia may be closely related to fetal development.4. Maternal serum adiponectin and plasma endothelin-1 was negatively correlated, suggesting that APN and ET-1 may serve as a risk factor for HDCP and an important indicator of its prognosis.