Association of arginine vasopressin (AVP) promoter polymorphisms with preeclampsia

Nutrigenetic Investigations in Preeclampsia

Background: Preeclampsia is a leading cause of pregnancy-related maternal and fetal morbidity and mortality. Although its precise cause and prevention remain unclear, risk factors such as overweight and inadequate nutrient intake (e.g., calcium, folic acid, and vitamin D) are known to increase its incidence. Recent research has focused on the genetic predisposition to preeclampsia, identifying polymorphisms that may affect enzyme or receptor function. This study aims to review existing literature examining the relationship between genetic polymorphisms, BMI (body mass index), and nutrient levels in preeclampsia to develop more actionable therapeutic strategies. Methods: A systematic review was conducted to analyze studies on the nutrigenetic relationship between BMI, micronutrients, and preeclampsia. Results: A total of 17 studies investigating 12 genes related to BMI and 10 studies exploring 3 genes in relation to micronutrient levels were included in the analysis. Several polymorphisms associated with preeclampsia were found to be influenced by maternal BMI or serum vitamin levels. The interactions between certain gene variants and these factors suggest that both BMI and micronutrient status may modify the risk of developing preeclampsia in genetically predisposed individuals. Conclusions: Our findings emphasize the potential for reanalyzing existing data by categorizing based on genotype and nutrient levels. This approach could yield more personalized dietary and therapeutic recommendations for managing preeclampsia. In the future, genetic information may support the development of tailored nutritional counseling during pregnancy to mitigate preeclampsia risk.

The relationship between arginine vasopressin gene polymorphisms and plasma copeptin and hypertensive disorders of pregnancy: a nested case-control study

OBJECTIVES

This study aims to explore the relationship between polymorphism of the arginine vasopressin (AVP) gene and plasma copeptin concentration with the occurrence of hypertension in pregnancy.

METHODS

We conducted a matched nested case-control study in Chinese women. The genotypes of rs3729965, rs3761249, rs1410713, rs2740204, and rs2282018 loci of AVP gene and plasma copeptin at 16-20 gestational weeks were detected in 288 patients with gestational hypertension (GH), 82 with preeclampsia (PE), and 14 with chronic hypertension with superimposed preeclampsia (CH-PE) and their healthy matched controls.

RESULTS

For every natural logarithm unit increment in copeptin, the risks of GH and PE/CH-PE increased by 5.556 (adjusted odds ratio [aOR]: 6.556, 95% confidence interval [CI]: 2.734-15.717) and 3.312 times (aOR: 4.312, 95% CI: 1.168-15.914). Under the dominant model, the genotype CC + CT of rs2282018 and GG + GT of rs3761249 had higher risks of GH than genotype TT, with aORs of 1.757 (95% CI: 1.077-2.867) and 1.814 (95% CI: 1.111-2.963). Allele A of rs3729965 loci had a lower risk of PE/CH-PE than allele G (aOR: 0.441, 95% CI: 0.199-0.978). However, the frequencies of rs1410713 and rs2740204 genotypes were not significantly different between cases and controls. The model of copeptin combined with the AVP gene and traditional factors (TFs) had a higher ability than the TFs model in predicting GH and PE/CH-PE.

CONCLUSION

Our study confirms that higher plasma copeptin and AVP gene variants are associated with the occurrence of GH and PE/CH-PE. The detection of copeptin and AVP gene in the early second trimester improves the predictive ability of TFs for GH and PE/CH-PE.

Copeptin in Patients with Pregnancy-Induced Hypertension

Pregnancy-induced hypertension (PIH) occurs in 6–8% of pregnancies, and increases the risk of many severe obstetric complications. The etiology of PIH has not been fully explained, and hence, treatment is only palliative in nature, and prevention is not fully effective. It has been proposed that PIH development is influenced by the arginine vasopressin pathway, whose surrogate biomarker is copeptin. The aim of this study is a prospective assessment of the relationship between the level of copeptin in pregnant women and the occurrence of PIH, and to identify its usefulness in predicting complications. The study involved a group of 21 pregnant women who developed PIH and 37 women with uncomplicated pregnancies as a control group. Blood samples were collected at the three trimesters of gestation (<13 HBD, between 13 and 26 and >26 HBD) and then frozen. Copeptin levels [pg/mL] were measured in serum samples obtained in the first, second and third trimesters of gestation from women in the PIH and control groups. The concentration of copeptin in the second and third trimesters of pregnancy was statistically significantly higher in the PIH group (p < 0.05). For copeptin determined in the first trimester, which could be used to screen for PIH, the area under the ROC curve was 0.650. The highest risk of PIH occurred in patients with high concentrations of copeptin in the first trimester of pregnancy and obesity OR = 5.5 (95% CI 1.0–31.3). The risk of PIH was augmented in patients with high levels of copeptin and an abnormal Doppler result of the uterine arteries OR = 28.4 (95% CI 5.3–152). In conclusion, copeptin levels were found to be elevated in pregnant women before the diagnosis of PIH; however, copeptin should not be used as a stand-alone marker. The combination of copeptin concentration with the other risk factors (diabetes, maternal age and preeclampsia in previous pregnancy) did not improve the diagnostic values of the use of copeptin in the PIH risk assessment, but the combination of copeptin concentration with BMI may be useful in clinical practice. Measurement of copeptin together with a Doppler examination of uterine arteries in the first trimester of pregnancy may be a useful marker in predicting the development of PIH.