Endothelin-1 and Thyroid Hormone Dysregulation: Potential Biomarkers for Early Detection of Pre-Eclampsia
DOI:
https://doi.org/10.55629/pakjpathol.v36i4.962Abstract
Objective: To evaluate and compare the serum thyroid hormone levels and endothelin-1 (ET-1) concentrations among pre-eclamptic and normotensive pregnant women and to determine their correlation with blood pressure.
Material and Methods: This cross-sectional comparative study was conducted at Liaquat University of Medical and Health Sciences (LUMHS), including 140 pregnant women—70 normotensive and 70 pre-eclamptic. The mean maternal age was 28 years (p=0.498) and mean gestational age was 32 weeks (p=0.799). Body Mass Index (BMI) averaged 26 kg/m² in both groups (p=0.724). Most participants were multiparous (70%, p=0.154). Pre-eclamptic women had significantly higher blood pressures (systolic 156.43 ± 20.36 mmHg; diastolic 103.57 ± 10.05 mmHg; p=0.001). Serum thyroid hormones (T3, T4, TSH) were analyzed by enzyme immunoassay using Cobas e411 (Hitachi) kits, while endothelin-1 levels were measured by radioimmunoassay following column chromatography extraction. Data were analyzed through SPSS version 26.0.
Results: Mean T3 levels were 2.36 ng/ml in normotensive and 1.28 ng/ml in pre-eclamptic women, while TSH levels were 2.17 ± 1.81 and 3.76 ± 1.93 µIU/ml, respectively. Mean ET-1 was significantly higher in pre-eclamptic women (53.30 ± 7.78) compared to normotensive (31.89 ± 6.28). Positive correlations were found between TSH and systolic blood pressure and between ET-1 and systolic blood pressure, while T3 and T4 showed negative correlations in pre-eclamptic women.
Conclusion: Pre-eclamptic women exhibit significant alterations in thyroid hormones and elevated endothelin-1 levels, suggesting hormonal imbalance and endothelial dysfunction as key contributors to pre-eclampsia pathogenesis.
Keywords: Pre-eclampsia; Thyroid hormones; Endothelin-1; Hypertension; Pregnancy; Endothelial dysfunction.
References
Meo SA, Hassain A. Metabolic physiology in pregnancy. J Pak Med Assoc. 2016; 66(9): S8-S10. Available from: https://www.archive.jpma.org. pk/PdfDownloadsupplements/255
Gyselaers W. Preeclampsia is a syndrome with a cascade of pathophysiologic events. J Clin Med. 2020; 9(7): 2245.
DOI: https://doi.org/10.3390/jcm9072245
Rana S, Lemoine E, Granger J, Karumanchi SA. Preeclampsia: Pathophysiology, challenges, and perspectives. Circ Res. 2019;124(7):1094–112.
DOI:https://doi.org/10.1161/circresaha.118.313276
Reische EC, Männistö T, Purdue-Smithe A, Kannan K, Kim UJ, Suvanto E, et al. The joint role of iodine status and thyroid function on risk for preeclampsia in finish women: A population-based nested case-control study. Biol Trace Elem Res. 2020; 199(6): 2131-7.
DOI: https://doi.org/10.1007/s12011-020-02341-2
Jamal B, Shaikh F, Memon MY. To determine the effects of copper, zinc and magnesium in patients with pre-eclampsia. J Liaquat Univ Med Heal Sci. 2017; 16(1): 53–7. Available from: https://www.lumhs.edu.pk/jlumhs/Vol16No01/pdfs/11.pdf
Santoro N, Braunstein GD, Butts CL, Martin KA, McDermott M, Pinkerton JV. Compounded bioidentical hormones in endocrinology practice: an endocrine society scientific statement. J Clin Endocrinol Metab, 101 (2016), pp. 1318-43.
DOI: https://doi.org/10.1210/jc.2016-1271
Azizi F, Delshad H. Thyroid derangements in pregnancy. IJEM. 2014;15: 491–508. Available from: https://ijem.sbmu.ac.ir/article-1-1521-en.pdf
Cignini P, Cafà EV, Giorlandino C, Capriglione S, Spata A, Dugo N. Thyroid physiology and common diseases in pregnancy: Review of literature. J Prenat Med. 2012; 6: 64–71. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC35 30964/pdf/64-71_cignini_pietro_def_bis.pdf
Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21(10): 1081–125. Available from: https://www.saegre.org.ar/biblioteca/tiroides/guia_asociacion_americana_tiroides.pdf
Chowdhary S, Aara S, Nazeer M, Allaqband M. Thyroid function tests in preeclampsia. Int J Med Sci Clin Invent. 2018; 5(3): 3606–9. Available from: https://valleyinternational.net/index.php/ijmsci/article/view/1113/1170
Dhananjaya BS, Sendil Kumaran D, Venkatesh G, Niranjan M, Shashiraj HK. Thyroid stimulating hormone (TSH) level as a possible indicator of pre-eclampsia. J Clin Diagnostic Res. 2011; 5(8): 1542–3. Available from: https://www.jcdr.net/articles/pdf/1778/11%20-%203369.pdf
Granger JP, Spradley FT, Bakrania BA. The endothelin system: A critical player in the pathophysiology of preeclampsia. Curr Hypertens Rep. 2018; 20(4): 32.
DOI: https://doi.org/10.1007/s11906-018-0828-4
Saleh L, Verdonk K, Visser W, Van Den Meiracker AH, Danser AHJ. The emerging role of endothelin-1 in the pathogenesis of pre-eclampsia. Ther Adv Cardiovasc Dis. 2016; 10(5): 282–93. DOI: https://doi.org/10.1177/1753944715624853
Hypertension in Pregnancy: Executive Summary. Obstet Gynecol. 2013; 122(5): 1122-31. DOI: https://doi.org/10.1097/01.aog.0000437382.03963.88
WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. 2011. ISBN 978-92-4-154833-5. Available from: https://iris.who.int/server/api/core/bitstreams/02f76d6d-4f9f-4662-84fe-e23c186e1594/content
Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises. Best Pract Res Clin Obstet Gynaecol. 2013; 27 (6): 877–84.
DOI:https://doi.org/10.1016/j.bpobgyn.2013.07.003
GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1459-544. DOI: https://doi.org/10.1016/s0140-6736(16)31012-1
Datta S, Kodali BS, Segal S. Obstetric Anesthesia Handbook. 5th ed. Springer Science & Business Media, New York, NY; 2010. 470. DOI: https://doi.org/10.1007/978-0-387-88602-2
Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005; 105(2): 239–45. DOI: https://doi.org/10.1097/01.aog.0000152345.99421.22
Chen H, Tao F, Fang X., Wang X. Association of hypoproteinemia in preeclampsia with maternal and perinatal outcomes: A retrospective analysis of high-risk women. J Res Med Sci. 2016; 21: 98. DOI: https://doi.org/10.4103/1735-1995.193170
Caraceni P, Domenicali M, Tovoli A, Napoli L, Ricci CS, Tufoni M, et al. Clinical indications for the albumin use: still a controversial issue. Eur J Intern Med. 2013; 24(8): 721-8. DOI: https://doi.org/10.1016/j.ejim.2013.05.015
Aggarwal PK, Chandel N, Jain V, Jha V. The relationship between circulating endothelin-1, soluble fms-like tyrosine kinase-1 and soluble endoglin in preeclampsia. J Hum Hypertens. 2012; 26 (4): 236-41.
DOI: https://doi.org/10.1038/jhh.2011.29
George E.M., Palei A.C., Granger J.P. Endothelin as a final common pathway in the pathophysiology of preeclampsia: Therapeutic implications. Curr Opin Nephrol Hypertens. 2012; 21 (2):157–162. DOI:https://doi.org/10.1097/MNH.0b013e328350094b
Aggarwal PK, Chandel N, Jain V, Jha V. The relationship between circulating endothelin-1, soluble Fms-like tyrosine kinase-1 and soluble endoglin in preeclampsia. J Hum. Hypertens. 2012; 26: 236–41.
Abdalvand A, Morton JS, Bourque SL, Quon AL, Davidge ST. Matrix metalloproteinase enhances big-endothelin-1 constriction in mesenteric vessels of pregnant rats with reduced uterine blood flow. Hypertension. 2013; 61: 488-93. DOI: https://doi.org/10.1161/hypertensionaha.111.00055
Nugent WH, Mishra N, Strauss JF, 3rd Walsh SW. Matrix metalloproteinase 1 causes vaso-constriction and enhances vessel reactivity to angiotensin ii via protease-Activated receptor 1. Reprod Sci. 2016; 23: 542–8.
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