The relationship between hypertension and plasma allantoin, uric acid, xanthine oxidase activity and nitrite, and their predictive capacity in severe preeclampsia

Abstract

It is controversial that uric acid (UA) levels are related to the severity of hypertension in preeclampsia (PE). Our aim in this study was to determine whether UA, xanthine oxidase activity (XOA), allantoin and nitrite levels are related to arterial blood pressure (BP) in PE. We formed a control group (n = 20) and a PE group (n = 20) for the study. Their BPs and plasma UA, XOA, allantoin and nitrite levels were measured. The values from the control and PE pregnant women were assessed via a Wilcoxon matched-pairs test. A Pearson correlation test was also performed. In addition, the diagnostic value of these tests was evaluated via receiver operating characteristic (ROC) analysis. The BP, UA, XOA and allantoin levels in the PE patients were found to be higher when compared with those of the pregnant controls. The UA, XOA and allantoin levels showed high correlations with BP in cases of PE. However, there was no superiority among the correlations. No differences were observed between the groups in terms of nitrite levels and the relationship between nitrite and BP. UA, XOA and allantoin levels may be high due to placental cell death because of abnormal trophoblastic activity observed in PE. Moreover, the reactive oxygen products that are created during the genetic material degradation may explain how UA, XOA and allantoin levels are related to BP. According to ROC analysis, UA, XOA and allantoin assays are reliable predictors for the determination of PE.

Maternal Oxidant-Antioxidant Homeostasis During Normotensive and Preeclamptic Pregnancy.

“…These correlations coincided with Elmas et al (25) who found serum levels of UA, XOA and allantoin levels showed high correlations with blood pressure in cases of PE.…”

“…In line with this finding, considering persistently elevated or progressively elevating liver enzymes as a manifestation of severe PE (33) , Atiba et al (25,34) reported positive correlation between serum MDA levels and serum levels of both AST and ALT and concluded that elevated liver enzymes seen in PE women may be due to free radical injury to the liver.…”

“…Also, Elmas et al (25) found blood pressure and serum levels of UA, xanthine oxidase activity (XOA) and allantoin levels were higher in PE patients when compared with pregnant controls and Shastri et al (26) reported significantly higher lipid peroxides and lower paraoxonase-1 activity during 1 st trimester in pregnant women with high hemoglobin than women with low/normal hemoglobin concentration. The obtained data go in hand with Pourghassem Gargari et al (27) who detected significantly higher serum levels of MDA and significantly lower TAC in women with PE compared to controls.…”

“…Thereafter, Bakacak et al (23) detected high serum Cu/Zn ratios in PE than in hypertensive and 37 normotensive women and documented that these increased ratios may reflect vascular complications of PE, and the ensuing increases in lipid peroxidation may play important pathogenic roles in PE. Elmas et al (25) attributed high serum UA, XOA and allantoin levels to placental cell death because of abnormal trophoblastic activity observed in PE.…”

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

“…Decreased placental perfusion due to impaired remodeling of spiral arteries might result in hypoxia [139]. UA level showed high correlation with BP in cases of PE [140]. In pregnant ladies suffering PE, serum tumor necrosis factor α (TNFα) and ICAM1 were significantly higher than control or hypertensive pregnant ladies.…”