Patologìâ (Dec 2019)
Factors of angiogenesis and placental hormones in pregnant women with arterial hypertension
Abstract
The changes of the factors of angiogenesis and hormones of pregnancy in pregnant women with hypertension of I and II stages has been studied inadequately and their interaction in such patients is not fully elucidated at present time. Aim. To detect peculiarities of angiogenesis factors and placental hormones in pregnant women with arterial hypertension I and II grades in comparison with results of healthy pregnant women. Materials and methods. A one-time study of pregnant women was performed in pregnancy of 12–13 weeks in all groups. 88 pregnant women were inspected. The 1st basic group consisted of 28 pregnant women with AH of I grade; the 2nd group consisted of 33 pregnant women with AH of II grade; the comparison group included 27 women without AH. The following hormones were determined: HCG, PG, E. Among the angiogenesis indices, the placental growth factor (PGF), as a pro-angiogenic factor and placental soluble fms-like tyrosine kinase (sFlt-1) was determined as an anti-angiogenic factor, sFlt-1/PGF ratio was also estimated. Statistical analysis was done by using “Statistica for Windows 13” (StatSoft Inc., № JPZ804I382130ARCN10-J). Results. Pregnant women in 1st group were the youngest: the average age was 26.4 ± 0.8 years versus 33.8 ± 0.6 years in 2nd group and 32.0 ± 1.0 years in control group, P ˂ 0.001. PGF levels were decreased in both 1st (17.5 ± 3.4 pg/ml) and 2nd groups (13.5 ± 2.5 pg/ml) in comparison with results in 3rd group (46.1 ± 7.0 pg/ml), P ˂ 0.001. We didn’t find statistical differences between results of women with AH of I and II degree, P ˃ 0.05. Contrary to previous results, sFlt-1 levels were increased in both 1st and 2nd groups, P ˂ 0.05: 1703.1 ± 99.2 pg/ml in 1st group and 1673.7 ± 93.5 pg/ml in 2nd group versus 1384.4 ± 77.1 pg/ml in control group, but they weren’t different between basic groups, P ˃ 0.05. As a result, sFlt-1/PGF ratio level was increased in both 1st (273.3 ± 54.6 units) and 2nd (415.8 ± 79.0 units) groups in comparison with control (46.6 ± 9.4 units), P ˂ 0.001. We didn’t set statistical differences in hormones levels among pregnant patients. PGF level was connected with E (r = -0.54, P ˂ 0.01) and HCG (r = -0.42, P ˂ 0.05) levels in pregnant women with AH of I degree. It was connected with HCG level in control group, but this correlation was contrary: r = +0.63, P ˂ 0.001. Conclusions. Pregnant women with AH in I trimester have disturbances in balance between pro-angiogenic and anti-angiogenic factors with prevalence of sFlt-1 and reducing of PGF in blood serum. Due to such disbalance in pregnant women with AH of I grade correlation between angiogenesis factors and hormones changed from direct to inverse.
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