Details
Category: Volume 07 Issue 07 July 2019
Hits: 1438

Title: Vitamin D in Prevention of Preeclampsia

Authors: Akanksha Tiwari, Dr Jyoti Batra, Dr Srikant Sharma, Dr Alpana Aggrawal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.38

Abstract

The present study aimed to analyse the relation between vitamin D and preeclampsia. 120 pregnant females with a single ton pregnancy (healthy/preeclamptic) were selected and their body mass index was determined. They were further divided into four groups; normotensive patients with body mass index<25 kg/m2 (Group-I, N=30‘CONTROL’), normotensive patients with body mass index>25 kg/m2 (Group-II, N=30), preeclamptic patients with body mass index<25 kg/m2 (Group-III, N=30), and preeclamptic patients with body mass index>25 kg/m2 (Group-IV, N=30). Their serum 25 OH D levels were analysed. Through the analysis, preeclamptic patients showed significantly reduced serum levels of vitamin D and a positive association between low vitamin D levels and preeclampsia was observed.

Keywords: Hypertension; Preeclampsia; 25 OHD; Vitamin D; Body Mass Index.

References

  1. James M. Roberts, Phyllis A. August, George Bakris, John R. Barton, Ira M. Bernstein, Maurice Druzin, Robert R. Gaiser, Joey P. Granger, Arun Jeyabalan, Donna D. Johnson, S. Ananth Karumanchi, Marshall D. Lindheimer, Michelle Y. Owens, George R. Saade, Baha M. Sibai, Catherine Y. Spong, Eleni Tsigas, James N. Martin Jr, Gerald F. Joseph Jr, Nancy O’Reilly, Alyssa Politzer, Sarah Son, Karina Ngaiza; Hypertension in Pregnancy; American College of Obstetricians and Gynecologists. Task Force on Hypertension in Pregnancy, developed by the Task Force on Hypertension in Pregnancy. ISBN 978-1-934984-28-4. RG575.5 618.3'6132—dc23. 201302252.
  2. Reena RP, Umadevi N, Ajitha BK. Severe Obstetric Morbidity: Prevalence, Risk Factors and Outcome. Ntl J of Community Med 2015; 6(2):33-35.
  3. World Health Organization. WHO recommendations for prevention and treatment of PE and eclampsia. Geneva: World Health Organization;2011
  4. Snydal S. Major Changes in Diagnosis and Management of PE. J Midwifery Womens Health. 2014; 59:596–605.
  5. Benachi Alexandra; Baptiste Amandine; Taieb Joëlle; Tsatsaris Vassilis; Guibourdenche Jean; SenatMarie-Victoire; Haidar Hazar; JaniJacques; Guizani Meriem; Jouannic Jean-Marie; Haguet Marie-Clotilde; Winer Norbert; Masson Damien; Courbebaisse Marie; Elie Caroline; Souberbielle Jean-Claude. Relationship between vitamin D status in pregnancy and the risk for PE: A nested case-control study. Clinical nutrition (Edinburgh, Scotland), ISSN: 1532-1983. Publication Year2019. PMID30799191. doi:1016/j.clnu.2019.02.015
  6. Zhu-mei Fu, Zhen-zhi Ma, Guo-jie Liu, Lan-ling Wang, YongGuo; Vitamins supplementation affects the onset of PE. Journal of the Formosan Medical Association, Volume 117, Issue 1, January 2018, Pages 6-13.
  7. Roberts JM,Hubel CA. The two stage model of preeclampsia: variations on the theme. 2009 Mar;30 Suppl A:S32-7. doi: 10.1016/j.placenta.2008.11.009. Epub 2008 Dec 13.
  8. Grundmann M, Haidar M, Placzko S, Niendorf R, Darashchonak N, Hubel CA, von Versen-Hoynck F. Vitamin D improves the angiogenic properties of endothelial progenitor cells.Am J Physiol Cell Physiol. 2012;303(9):C954–C962. doi: 10.1152/ajpcell.00030.2012. 
  9. Merke J, Milde P, Lewicka S, Hugel U, Klaus G, Mangelsdorf DJ, Haussler MR, Rauterberg EW, Ritz E. Identification and regulation of 1,25-dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3. Studies in cultured bovine aortic endothelial cells and human dermal capillaries.J Clin Invest. 1989; 83(6):1903–1915. doi: 10.1172/JCI114097. 
  10. Cardus A, Parisi E, Gallego C, Aldea M, Fernandez E, Valdivielso JM. 1,25-Dihydroxyvitamin D3 stimulates vascular smooth muscle cell proliferation through a VEGF-mediated pathway.Kidney Int. 2006;69(8):1377–1384. doi: 10.1038/sj.ki.5000304. 
  11. Brodowski L, Burlakov J, Myerski AC, von Kaisenberg CS, Grundmann M, Hubel CA, von Versen-Hoynck F. Vitamin D prevents endothelial progenitor cell dysfunction induced by sera from women with PE or conditioned media from hypoxic placenta.PLoS One. 2014;9 (6):e98527. doi: 10.1371/journal.pone.0098527. 
  12. Woodham PC, Brittain JE, Baker AM, Long DL, Haeri S, Camargo CA, Jr, Boggess KA, Stuebe AM. Midgestation maternal serum 25-hydroxyvitamin D level and soluble fms-like tyrosine kinase 1/placental growth factor ratio as predictors of severe PE.2011;58(6):1120–1125. doi: 10.1161/ HYPERTENSIONAHA.111.179069. 
  13. Gilbert JS, Babcock SA, Granger JP.:Hypertension produced by reduced uterine perfusion in pregnant rats is associated with increased soluble fms-like tyrosine kinase-1 expression.Hypertension 50: 1142–1147, 2007.
  14. Makris A, Thornton C, Thompson J, Thomson S, Martin R, Ogle R, Waugh R, McKenzie P, Kirwan P, Hennessy A.:Uteroplacental ischemia results in proteinuric hypertension and elevated sFLT-1. Kidney Int71: 977–984, 2007.
  15. Maynard SE, Min JY, Merchan J, Lim KH, Li J, Mondal S, Libermann TA, Morgan JP, Sellke FW, Stillman IE, Epstein FH, Sukhatme VP, Karumanchi SA.: Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in PE. J Clin Invest 111: 649–658, 2003.
  16. Su-ling Ma, Xiao-yu Tian, Ya-qi Wang, Hui-feng Zhang and Lei Zhang. Vitamin D Supplementation Prevents Placental Ischemia Induced Endothelial Dysfunction by Downregulating Placental Soluble FMS-Like Tyrosine Kinase-1. Published Online: 1 Dec 2017 https://doi.org/10.1089/dna.2017.3817.
  17. Kulandavelu S, Whiteley KJ, Qu D, Mu J, Bainbridge SA, Adamson SL.:Endothelial nitric oxide synthase deficiency reduces uterine blood flow, spiral artery elongation, and placental oxygenation in pregnant mice. Hypertension 60: 231–238, 2012.
  18. Lowe DT:Nitric oxide dysfunction in the pathophysiology of PE. Nitric Oxide 4: 441–458, 2000.
  19. Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med. 2010;88(5):441–450. doi: 10.1007/s00109-010-0590-9.
  20. Noyola-Martinez N, Diaz L, Avila E, Halhali A, Larrea F, Barrera D. Calcitriol downregulates TNF-alpha and IL-6 expression in cultured placental cells from preeclamptic women. Cytokine. 2013;61(1):245–250. doi: 10.1016/j.cyto.2012.10.001.
  21. Martinez-Miguel P, Valdivielso JM, Medrano-Andres D, Roman-Garcia P, Cano-Penalver JL, Rodriguez-Puyol M, Rodriguez-Puyol D, Lopez-Ongil S. The active form of vitamin D, calcitriol, induces a complex dual upregulation of endothelin and nitric oxide in cultured endothelial cells. Am J Physiol Endocrinol Metab. 2014 Dec 15;307(12):E1085-96. Doi: 10.1152/ajpendo.00156.2014. Epub 2014 Oct 21.
  22. Bainbridge SA, Farley AE, McLaughlin BE, Graham CH, Marks GS, Nakatsu K, Brien JF, Smith GN.:Carbon monoxide decreases perfusion pressure in isolated human placenta. Placenta 23: 563–569, 2002.
  23. Zhao H, Wong RJ, Doyle TC, Nayak N, Vreman HJ, Contag CH, Stevenson DK.:Regulation of maternal and fetal hemodynamics by heme oxygenase in mice. Biol Reprod 78: 744–751, 2008
  24. Lyall F, Barber A, Myatt L, Bulmer JN, Robson SC.:Hemeoxygenase expression in human placenta and placental bed implies a role in regulation of trophoblast invasion and placental function. FASEB J 14: 208–219, 2000
  25. McCaig D, Lyall F.:Inhibitors of heme oxygenase reduce invasion of human primary cytotrophoblast cells in vitro. Placenta 30: 536–538, 2009
  26. Ahmed A, Rahman M, Zhang X, Acevedo CH, Nijjar S, Rushton I, Bussolati B, St John J.:Induction of placental heme oxygenase-1 is protective against TNFalpha-induced cytotoxicity and promotes vessel relaxation. Mol Med 6: 391–409, 2000 
  27. Dulak J, Deshane J, Jozkowicz A, Agarwal A.:Heme oxygenase-1 and carbon monoxide in vascular pathobiology: Focus on angiogenesis. Circulation 117: 231–241, 2008 
  28. Zhao H, Wong RJ, Kalish FS, Nayak NR, Stevenson DK.:Effect of heme oxygenase-1 deficiency on placental development. Placenta 30: 861–868, 2009 
  29. Yachie A, Niida Y, Wada T, Igarashi N, Kaneda H, Toma T, Ohta K, Kasahara Y, Koizumi S.:Oxidative stress causes enhanced endothelial cell injury in human heme oxygenase-1 deficiency. J Clin Invest 103: 129–135, 1999. 
  30. Linzke N, Schumacher A, Woidacki K, Croy BA, Zenclussen AC.:Carbon monoxide promotes proliferation of uterine natural killer cells and remodeling of spiral arteries in pregnant hypertensive heme oxygenase-1 mutant mice. Hypertension 63: 580–588, 2014
  31. Barber A, Robson SC, Myatt L, Bulmer JN, Lyall F.:Heme oxygenase expression in human placenta and placental bed: Reduced expression of placenta endothelial HO-2 in PE and fetal growth restriction. FASEB J 15: 1158–1168, 2001.
  32. Farina A, Sekizawa A, De Sanctis P, Purwosunu Y, Okai T, Cha DH, Kang JH, Vicenzi C, Tempesta A, Wibowo N, Valvassori L, Rizzo N.:Gene expression in chorionic villous samples at 11 weeks’ gestation from women destined to develop PE. Prenat Diagn 28: 956–961, 2008
  33. Cudmore M, Ahmad S, Al-Ani B, Fujisawa T, Coxall H, Chudasama K, Devey LR, Wigmore SJ, Abbas A, Hewett PW, Ahmed A.:Negative regulation of soluble Flt-1 and soluble endoglin release by heme oxygenase-1. Circulation 115: 1789–1797, 2007
  34. Langer B, Grima M, Coquard C, Bader AM, Schlaeder G, Imbs JL. Plasma active renin, angiotensin I, and angiotensin II during pregnancy and in PE.Obstet Gynecol. 1998;91(2):196–202. doi: 10.1016/S0029-7844(97)00660-1. 
  35. Velloso EP, Vieira R, Cabral AC, Kalapothakis E, Santos RA. Reduced plasma levels of angiotensin-(1-7) and renin activity in preeclamptic patients are associated with the angiotensin I- converting enzyme deletion/deletion genotype.Brazilian J Med Biol Res. 2007;40(4):583–590. doi: 10.1590/S0100-879X2007000400018.
  36. Faulkner JL, Amaral LM, Cornelius DC, Cunningham MW, Ibrahim T, Heep A, Campbell N, Usry N, Wallace K, Herse F, et al. Vitamin D supplementation reduces some AT1-AA-induced downstream targets implicated in PE including hypertension.Am J Physiol Regul Integr Comp Physiol. 2017;312(1):R125–R131. doi: 10.1152/ajpregu.00218.2016. 
  37. Dechend R, Viedt C, Müller DN, Ugele B, Brandes RP, Wallukat G, Park JK, Janke J, Barta P, Theuer J, Fiebeler A, Homuth V, Dietz R, Haller H, Kreuzer J, Luft FC.:AT1 receptor agonistic antibodies from preeclamptic patients stimulate NADPH oxidase. Circulation 107: 1632–1639, 2003
  38. Zhou CC, Ahmad S, Mi T, Xia L, Abbasi S, Hewett PW, Sun C, Ahmed A, Kellems RE, Xia Y.:Angiotensin II induces soluble fms-Like tyrosine kinase-1 release via calcineurin signaling pathway in pregnancy. Circ Res 100: 88–95, 2007 
  39. Zhou CC, Irani RA, Zhang Y, Blackwell SC, Mi T, Wen J, Shelat H, Geng YJ, Ramin SM, Kellems RE, Xia Y.:Angiotensin receptor agonistic autoantibody-mediated tumor necrosis factor-alpha induction contributes to increased soluble endoglin production in PE. Circulation 121: 436–444, 2010 
  40. LaMarca B, Parrish M, Ray LF, Murphy SR, Roberts L, Glover P, Wallukat G, Wenzel K, Cockrell K, Martin JN Jr., Ryan MJ, Dechend R.: Hypertension in response to autoantibodies to the angiotensin II type I receptor (AT1-AA) in pregnant rats: Role of endothelin-1. Hypertension 54: 905–909, 2009 
  41. Roth CL, Elfers CT, Figlewicz DP, Melhorn SJ, Morton GJ, Hoofnagle A, et al. Vitamin D deficiency in obese rats exacerbates nonalcoholic fatty liver disease and increases hepatic resistin and toll-like receptor activation. Hepatology (2012) 55:1103–11.10.1002/hep.24737.
  42. Oermann E, Bidmon HJ, Witte OW, Zilles K. Effects of 1alpha,25 dihydroxyvitamin D3 on the expression of HO-1 and GFAP in glial cells of the photothrombotically lesioned cerebral cortex. J Chem Neuroanat (2004) 28:225–38.10.1016/j.jchemneu.2004.07.003.

Corresponding Author

Dr Jyoti Batra

Dean (Research) and Professor, Department of Biochemistry, Santosh Medical College and Hospital, Ghaziabad, India