Clinical InvestigationAlterations in Lipid Profile, Zinc and Copper Levels and Superoxide Dismutase Activities in Normal Pregnancy and Preeclampsia☆,☆☆
Introduction
Preeclampsia (PE) is a serious complication that occurs during the second and third trimester of pregnancy and affects the health of both the mother and fetus.1 It is a rapidly progressive condition characterized by proteinuria, hypertension and edema.2 Despite advances in the management of PE, it is still the main cause of maternal and perinatal mortality, complicating 5-10% of pregnancies worldwide.3 In Iran, the prevalence of PE was reported to be 1-8% of pregnancies.4
Although the etiology and pathogenesis of PE remain undefined, the occurrence of oxidative stress (OS) is a feature of this disease.5, 6, 7 However, there are controversial reports regarding the serum levels of antioxidant enzymes. For instance, Ilhan et al6 reported that superoxide dismutase (SOD) levels were reduced in the serum of patients with PE. However, Sharma et al5 showed an increase in serum SOD levels in patients with PE compared to a control group. Furthermore, another study demonstrated that there was no significant difference in the serum levels of antioxidant enzymes, such as catalase and SOD, between the control and PE groups.8
SODs are a family of metalloenzymes that catalyze the conversion of superoxide radical () to oxygen (O2) and hydrogen peroxide (H2O2). Therefore, they are involved in cellular protection against the toxicity caused by OS.9, 10 These enzymes carry out catalysis via a general mechanism that involves the sequential reduction and oxidation of the metals such as manganese (MnSOD in mitochondria and peroxisomes), copper and zinc (CuZnSOD in the cytosol and in the extracellular space).11 Because of the biological role of these metals in endogenous antioxidant enzymes, some studies have evaluated the serum levels of these elements, and controversial results have been reported. Several authors show decreased or unchanged levels of these elements,12, 13, 14 while others demonstrate increased levels of trace elements.6, 15, 16
Furthermore, the association of alteration of serum lipid profile in PE is well documented. Lipid alterations may lead to a reduction in the prostacyclin-thromboxane A2 (PGI2/TXA2) ratio. The altered prostaglandin ratio might stimulate increased lipid peroxidation and promote OS in PE.17 Race and ethnicity play an important role in the development of PE, and so far, no studies have been performed on zinc (Zn) and copper (Cu) combined with related antioxidant enzymes, such as SOD, in Iranian pregnant women with PE. Therefore, we decided to conduct a study in this field.
The aim of this study was to assess lipid profile status and the antioxidative systems in PE by measuring plasma Zn and Cu levels and SOD activities in pregnant women with or without PE.
Section snippets
Population Study
The case-control study was carried out at Qaem, Imam Reza and Omollbanin hospitals in Mashhad, Iran, from June 2014-May 2015. A total of 200 subjects (100 women with PE (PE group) and 100 normotensive pregnant women (control group), ages 16-42 years) were included in this study. Selected patients and healthy volunteers were matched for age and gestation age.
PE was defined as proteinuria (1+ on dipstick urinalysis or higher), hypertension (140/90 mm Hg or higher) and edema during the second and
Results
The PE group and control group were well matched for age and gestation age. Weight and BMI were significantly different between the groups (P < 0.001).
The PE group had significantly higher systolic and diastolic blood pressure compared to the control group (P < 0.001) (Table 1). In the PE group, urinalysis showed 65% at the 1+ level, 28% at the 2+ level and 7% at the 3+ level whereas all controls were nil or trace. History of PE in a previous pregnancy was 1% and 43% in control group and PE
Discussion
PE is a complication during pregnancy, which may threaten the life of both mother and fetus.1 Many studies have divulged that OS plays a main role in the initiation and development of many vascular disorders, including atherosclerosis, hypertension and so forth.21, 22 This study was conducted based on the hypothesis that OS may play a major role in the development of PE. In this study, we evaluated the concentration of plasma lipid profile levels (TC, TG, LDL-C and HDL-C), Zn and Cu along with
Conclusion
This study reports on lipid profile, Zn and Cu status and SOD activity in preeclamptic women as compared with normotensive pregnant women. Our results show the levels of TG and HDL-C to be significantly higher as well as the levels of Zn and Cu to be significantly lower in plasma of patients with PE compared with controls. Additionally, enhanced SOD activity was shown in patients with PE when compared to normotensive pregnant women. We suggest that the possible pathogenesis of PE is OS caused
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2022, Journal of Trace Elements in Medicine and BiologyCitation Excerpt :Our findings showed that higher copper levels were associated with a lower preeclampsia risk, consistent with the results of earlier similar studies [30,31]. A case-control study reported that compared with healthy pregnant women, plasma levels of copper in women with preeclampsia were significantly reduced [32]. Similarly, Acikgoz, S also observed significantly low copper levels in preeclampsia patients, compared to healthy pregnant women [33].
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2021, PharmaNutritionCitation Excerpt :Thus, a physiological decrease in zinc levels can potentially impair the antioxidant capacity during pregnancy. Few studies have reported that deficiency of zinc, iron, copper, calcium, and magnesium is associated with an increased risk of preeclampsia [100–102]. However, clinical studies elucidating the significant role of zinc alone in the management of preeclampsia are still awaited.
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Financial support: This work was supported financially by the grant from Mashhad University of Medical Science (grant number 921939).
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The authors have no conflict of interest to disclose.