The Correlation of L-citrulline Levels with Blood Pressure in Severe Preeclampsia

Abstract

BACKGROUND: Based on 'vascular disorder of pregnancy' terminology, preeclampsia primarily was not a hypertensive disorder, but a vascular disorder (general vasospasm) in pregnancy due to idiopathic etiology. The overall incidence of preeclampsia was 5-14% of all pregnancies. One of the substances responsible for regulating vascular tone is nitric oxide (NO), which produced in endothelial blood vessels. NO and L-citrulline are produced altogether by the reaction between L-arginine and oxygen. L-citrulline levels reflected NO production. This study was aimed to assess the correlation between the L-citrulline level and blood pressure in severe preeclampsia.METHODS: This cross-sectional study was done in Dr. M. Djamil Central General Hospital, Padang, Indonesia The sample size was 36 samples of pregnant women with severe preeclampsia and had yet been given antihypertensive therapy. Sampling was done by consecutive sampling from Obstetrics and Gynecology Division. After maternal examination and measurements L-citrulline levels of cubital venous blood by using enzyme-linked immunosorbent assay (ELISA) method, Pearson correlation was performed to assess the relationship between variables for normally distributed data and Spearman's correlation for abnormal distribution data with significance level p<0.05.RESULTS: Means of L-citrulline levels, systolic blood pressure, diastolic blood pressure, and arterial pressure (MAP) were 87.21 nmol/mL, 179.4 mmHg, 108.3mmHg, and 132.1 mmHg, respectively. Correlation of the L-citrulline level with systolic blood pressure, diastolic blood pressure, and MAP were -0.08, -0.175, and -0.136 (p>0.05), respectively.CONCLUSION: L-citrulline levels had no correlation with blood pressure in severe preeclampsia.KEYWORDS: L-citrulline levels, blood pressure, severe preeclampsia

L-Citrulline Level in Pregnant Adolescent With Severe Preeclampsia Compared to Without Preeclampsia: A Cross-sectional Study

“…Statistical correlation test between the blood pressure and L-citrulline levels indicates that there is no correlation between L-citrulline levels and these three parameters (P > 0.005). The results in this study are similar to a previous study conducted in 36 heavily preeclampsia women (29). The study found that L-citrulline levels did not correlate with systolic blood pressure, diastolic blood pressure, and MAP.…”

“…One of the pharmacological methods is the administration of L-arginine. Research conducted on animals and women shows the presence of beneficial effects (29,32).…”

L-citrulline ameliorates pathophysiology in a rat model of superimposed preeclampsia

“…One study have reported that citrulline can decrease blood pressure and improve vascular function in obese pregnant women 48 . Another study found no correlation between citrulline level and blood pressure in severe preeclampsia 49 . In a small-cohort of patients with severe preeclampsia (n=17), higher plasma citrulline levels were found comparing with controls or patients with mild or moderate preeclampsia 50 .…”

Transthyretin, Immature Platelet Fraction, and Mean Platelet Volume in Normotensive and Preeclampsia Pregnancy

“…(5) Preeclampsia is considered a multisystemic disease with non-specific clinical features, but it usually characterized by increased blood pressure, however the exact cause is still unknown. (6)(7)(8) The existing theory shows the relation between preeclampsia and abnormal placentation, that is the failure of cytotrophoblast invasion to the spiral arteries. This condition causes placental ischemia and hypoxia, increases oxidative stress, endothelin metabolism disorder or endothelial dysfunction, and stimulates systemic inflammation.…”