Clinical characteristics and analysis of changes in amino acid and organic acid profiles in the urine of patients at risk of preeclampsia
- 作者: Оshkhunova M.S.1, Chagovets V.V.1, Novoselova A.V.1, Muminova K.T.1, Gorina K.A.1, Khodzhaeva Z.S.1, Frankevich V.E.1
-
隶属关系:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
- 期: 编号 8 (2023)
- 页面: 56-66
- 栏目: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/585243
- DOI: https://doi.org/10.18565/aig.2023.48
- ID: 585243
如何引用文章
详细
The etiology of preeclampsia remains unclear; however, pathophysiological changes in multiple metabolic pathways are observed in this condition. Studying urine metabolites in preeclampsia can help identify potential biomarkers for improved clinical diagnosis and enhance our understanding of the mechanisms underlying its development.
Objective: To determine the characteristic features of urine composition in pregnant women at risk of preeclampsia or in those who have developed preeclampsia.
Materials and methods: The study utilized urine samples collected from pregnant women at 11–14, 22–25, and 32–35 weeks of gestation. Patients were categorized into three groups: Group I consisted of 13 women with physiological pregnancies, Group II comprised 13 patients at high risk of developing preeclampsia, and Group III included five pregnant women with diagnosed preeclampsia. Clinical, laboratory, and instrumental methods, including extended combined first-trimester screening, were employed. Additionally, the composition of amino acids and organic acids in the urine was analyzed using liquid chromatography with mass spectrometric detection.
Results: Preeclampsia diagnosis was based on the 2021 clinical guidelines of the Ministry of Health of Russia. Group III exhibited a significantly higher incidence of complicated obstetric and gynecological history, including antenatal fetal death (n=2, 40%) and a history of preeclampsia (n=3, 60%), than Group II, where only one patient (7.7%) had a history of preeclampsia. The patients in the control group did not have a complicated reproductive history (p<0.001). Chronic arterial hypertension was more prevalent in Group III (n=4, 80%). Significant differences were observed in the levels of proline, aspartate, and malic acid when comparing Group I to Group III, as well as proline, alpha-ketoglutarate, and 3-hydroxy-3-methylglutaric acid when comparing Group II to Group III
Conclusion: This study identified specific urinary metabolites whose levels were significantly different in patients with a healthy pregnancy, patients at risk of developing preeclampsia, and those diagnosed with preeclampsia at different gestational ages. Urine metabolite profiling is a promising method for predicting pre-eclampsia.
全文:
![受限制的访问](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
作者简介
Madina Оshkhunova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
编辑信件的主要联系方式.
Email: madina.oshkhunova@mail.ru
PhD Student at the High-risk Pregnancy Department
俄罗斯联邦, MoscowVitaliy Chagovets
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: vvchagovets@gmail.com
PhD, Head of the Laboratory of Metabolomics and Bioinformatics
俄罗斯联邦, MoscowAnastasia Novoselova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: a_novoselova@oparina4.ru
Researcher at the Laboratory of Metabolomics and Bioinformatics
俄罗斯联邦, MoscowKamilla Muminova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: kamika91@mail.ru
PhD, Researcher at the High Risk Pregnancy Department
俄罗斯联邦, MoscowKsenia Gorina
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: k_gorina@oparina4.ru
PhD, Researcher at the High Risk Pregnancy Department
俄罗斯联邦, MoscowZulfia Khodzhaeva
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: zkhodjaeva@mail.ru
Dr. Med. Sci., Professor, Deputy Director of Obstetrics Institute
俄罗斯联邦, MoscowVladimir Frankevich
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: v_frankevich@oparina4.ru
Dr. Sci. (Physics and Mathematics), Head of the Department of Proteomics of Human Reproduction Department
俄罗斯联邦, Moscow参考
- Uzan J., Carbonnel M., Piconne O., Asmar R., Ayoubi J.M. Pre-eclampsia: Pathophysiology, diagnosis, and management. Vasc. Health Risk Manag. 2011; 7: 467-74. https://dx.doi.org/10.2147/VHRM.S2018.
- Turner E., Brewster J.A., Simpson N.A.B., Walker J.J., Fisher J. Plasma from women with preeclampsia has a low lipid and ketone body content - a nuclear magnetic resonance study. Hypertens Pregnancy. 2007; 26(3): 329-42. https://dx.doi.org/10.1080/10641950701436073.
- Turner E., Brewster J.A., Simpson N.A.B.., Walker J.J., Fisher J. Aromatic amino acid biomarkers of preeclampsia - A nuclear magnetic resonance investigation. Hypertens Pregnancy. 2008; 27(3): 225-35. https://dx.doi.org/10.1080/10641950801955725.
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройцства во время беременности. 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Preeclampsia. Eclampsia. Edema, proteinuria, and hypertensive disorders during pregnancy. 2021. (in Russian)].
- Wold S., Sjöström M., Eriksson L. PLS-regression: a basic tool of chemometrics. Chemom. Intell. Lab. Syst. 2001; 58(2): 109-30.
- Thevenot E.A., Roux A., Xu Y., Ezan E., Junot C. Analysis of the human adult urinary metabolome variations with age, body mass index, and gender by implementing a comprehensive workflow for univariate and OPLS statistical analyses. J. Proteome Res. 2015; 14(8): 3322-35. https://dx.doi.org/10.1021/acs.jproteome.5b00354.
- Rolnik D., Nicolaides K., Poon L. Prevention of preeclampsia with aspirin. Am. J. Obstet. Gynecol. 2022; 226(Suppl. 2): S1108-19. https://dx.doi.org/10.1016/ j.ajog.2020.08.045.
- Liu L.X., Arany Z. Maternal cardiac metabolism in pregnancy. Cardiovasc. Res. 2014; 101(4): 545-53. https://dx.doi.org/10.1093/cvr/cvu009.
- Rossary A., Farges M.C., Lamas B., Miles E.A., Noakes P.S., Kremmyda L.S. et al. Increased consumption of salmon during pregnancy partly prevents the decline of some plasma essential amino acid concentrations in pregnant women. Clin. Nutr. 2014; 33(2): 267-73. https://dx.doi.org/10.1016/j.clnu.2013.04.013.
- Cetin I., Nobile De Santis M.S., Taricco E., Radaelli T., Teng C., Ronzoni S. et al. Maternal and fetal amino acid concentrations in normal pregnancies and in pregnancies with gestational diabetes mellitus. Am. J. Obstet. Gynecol. 2005; 192(2): 610-7. https://dx.doi.org/10.1016/j.ajog.2004.08.011.
- Bahado-Singh R.O., Syngelaki A., Mandal R., Graham S.F., Akolekar R., Han B. et al. Metabolomic determination of pathogenesis of late-onset preeclampsia. J. Matern. Neonatal Med. 2017; 30(6): 658-64. https://dx.doi.org/10.1080/ 14767058.2016.1185411.
- Sovio U., McBride N., Wood A.M., Masconi K.L., Cook E., Gaccioli F. et al. 4-Hydroxyglutamate is a novel predictor of pre-eclampsia. Int. J. Epidemiol. 2020; 49(1): 301-11. https://dx.doi.org/10.1093/ije/dyz098.
- Harville E.W., Li Y.Y., Pan K., McRitchie S., Pathmasiri W., Sumner S. Untargeted analysis of first trimester serum to reveal biomarkers of pregnancy complications: a case–control discovery phase study. Sci. Rep. 2021; 11(1): 3468. https://dx.doi.org/10.1038/s41598-021-82804-1.
- Okorie O.N., Dellinger P. Lactate: Bbiomarker and potential therapeutic target. Crit. Care Clin. 2011; 27(2): 299-326. https://dx.doi.org/10.1016/ j.ccc.2010.12.013.
- Peguero A., Parra R.A., Carrillo S.P., Rojas-Suarez J., Figueras F. Association of plasma lactate concentration at admission of severe preeclampsia to maternal complications. Pregnancy Hypertens. 2019; 17: 89-93. https://dx.doi.org/10.1016/j.preghy.2019.05.003.
- Andersen L.W., Mackenhauer J., Roberts J.C., Berg K.M., Cocchi M.N., Donnino M.W. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin. Proc. 2013; 88(10): 1127-40. https://dx.doi.org/10.1016/j.mayocp.2013.06.012.
- Kraut J.A., Madias N.E. Lactic acidosis. N. Engl. J. Med. 2014; 371(24): 2309-19. https://dx.doi.org/10.1056/NEJMra1309483.
- Kay H.H., Zhu S., Tsoi S. Hypoxia and lactate production in trophoblast cells. Placenta. 2007; 28(8-9): 854-60. https://dx.doi.org/10.1016/ j.placenta.2006.11.011.
- Settle P., Mynett K., Speake P., Champion E., Doughty I.M., Sibley C.P. et al. Polarized lactate transporter activity and expression in the syncytiotrophoblast of the term human placenta. Placenta. 2004; 25(6): 496-504. https://dx.doi.org/10.1016/j.placenta.2003.11.009.
- Rolnik D., Wright D., Poon L., Syngelaki A., O'Gorman N. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet. Gynecol. 2017; 50(4): 492-5. https://dx.doi.org/10.1002/ uog.18816.
补充文件
![](/img/style/loading.gif)