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Benevides FT, Fonsêca da Silva FL, de Oliveira DL, Matos WO, Dos Santos Dias T, de Sousa Almondes KG, Gomes MDM, de Oliveira AC, de Azevedo DV, Maia CSC. Zinc, antioxidant enzymes in preeclampsia, and association with newborn outcome. J Trace Elem Med Biol 2024; 85:127471. [PMID: 38810519 DOI: 10.1016/j.jtemb.2024.127471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND The etiology of preeclampsia (PE) may be associated with the increased of production of reactive species and decreased antioxidant activity of enzymes. Inadequate intake of Zn can affect gestational health due to its biological functions, such as its role in the antioxidant defense system. The study aimed to assess the nutritional status of Zn and antioxidant enzymes in postpartum women and its correlation with neonatal outcomes. METHODS A cross-sectional analytical study was carried out at a referral gynecology and obstetrics hospital. A total of 119 women (PE = 58, HP = 61) participated in the study. A quantitative food-frequency questionnaire was used to assess food consumption and further analyze the dietary Zn levels. Zinc levels in plasma and erythrocytes samples were analyzed by flame atomic absorption spectrometry, catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels were determined by UV-Vis spectrophotometry. RESULTS Plasma and dietary intake Zn results were considered adequate and without statistical difference between groups. SOD levels were significantly higher in the HP group (p = 0.011), and CAT levels were higher in the PE group (p = 0.050). There was a positive correlation between SOD activity in women with PE and the weight of their newborns (r = 0.336, p=0.021). CONCLUSION The results showed adequate Zn levels (consumption and serum levels) in the groups studied, although with a reduction of plasma Zn in the PE group compared to the PH group. Zinc in plasma fractions and erythrocytes are important markers for oxidative stress, in particular, plasma Zn seems to be related to the rapid response to preeclampsia. The activity of antioxidant enzymes was elevated in the groups studied. Better SOD activity improves birth weight in children of pregnant women with preeclampsia.
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Affiliation(s)
- Fernanda Teixeira Benevides
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil
| | - Francisco Luan Fonsêca da Silva
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil; Laboratory of Applied Chemistry (LEQA), Department of Analytical Chemistry and Physical Chemistry, Federal University of Ceará, Campus Pici, Fortaleza, Ceará 60455-760, Brazil; Education and Integrated Science Faculty of Crateus, State University of Ceará, Crateús, Ceará 63704-155, Brazil.
| | - Denise Lima de Oliveira
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil; University of Fortaleza, 1321 Washington Soares Ave, Fortaleza, Ceará 60811-905, Brazil
| | - Wladiana Oliveira Matos
- Laboratory of Applied Chemistry (LEQA), Department of Analytical Chemistry and Physical Chemistry, Federal University of Ceará, Campus Pici, Fortaleza, Ceará 60455-760, Brazil
| | - Thaynan Dos Santos Dias
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil
| | - Kaluce Gonçalves de Sousa Almondes
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil
| | | | - Ariclécio Cunha de Oliveira
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil
| | - Daniela Vasconcelos de Azevedo
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil
| | - Carla Soraya Costa Maia
- Pos-Graduate Program in Nutrition and Health, State University of Ceará, 1700 Dr. Silas Munguba Ave, Campus Itaperi, Fortaleza, Ceará 60.714.903, Brazil.
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Hamdan HZ, Hamdan SZ, Adam I. Association of Selenium Levels with Preeclampsia: A Systematic Review and Meta-analysis. Biol Trace Elem Res 2023; 201:2105-2122. [PMID: 35687295 DOI: 10.1007/s12011-022-03316-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/06/2022] [Indexed: 11/02/2022]
Abstract
Several observational studies have shown inconclusive findings on the association between selenium levels and preeclampsia. This systematic review and meta-analysis was conducted to clarify the association between selenium levels and preeclampsia. The databases PubMed, Google Scholar, ScienceDirect, and the Cochrane Library were searched for studies which investigated selenium levels with preeclampsia and which were published up to April 2022. The overall standardized mean differences (SMD) of selenium levels between cases and controls were measured. Sensitivity analysis, reporting bias, subgroup analysis, and meta-regression were performed for the estimate. The meta-analysis was calculated using the "meta" package in the open-source software R. A total of 26 studies with 1855 preeclampsia cases compared with 3728 healthy pregnant controls were included. The level of selenium was significantly lower in cases of preeclampsia compared with the controls [SMD = - 0.85; 95% confidence interval (CI): (- 1.46, - 0.25); P = < 0.01). As there was significant heterogeneity [I2 = 96%, Cochran's Q = 620.47; P = < 0.01], the random effects model was used. A stratified meta-analysis revealed that selenium levels were significantly lower in the cases compared with the controls among pregnant women from the African continent [SMD = - 1.15 (- 1.65, - 0.65); P = < 0.01]. Likewise, the same pattern was observed among women from middle- and low-income countries [SMD = - 1.32 (- 2.22, - 0.42); P = < 0.01]. None of the investigated factors (Modified Newcastle-Ottawa Scale quality score, year of publication, and sample size) showed significant association with the selenium SMD. The level of certainty of this evidence is "low certainty," as calculated by the GRADEpro GDT online tool. This meta-analysis with low level of evidence certainty revealed that low selenium level is associated significantly with preeclampsia. This pattern is also observed in women from the African continent and women from low- or middle-income countries. Further studies with different prospective designs and detailed patient characteristics are needed to consolidate this evidence.
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Affiliation(s)
- Hamdan Z Hamdan
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, P.O. BOX. 991, Unaizah, Kingdom of Saudi Arabia.
- Faculty of Medicine, Al-Neelain University, Khartoum, Sudan.
| | | | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
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Kurlak LO, Scaife PJ, Briggs LV, Broughton Pipkin F, Gardner DS, Mistry HD. Alterations in Antioxidant Micronutrient Concentrations in Placental Tissue, Maternal Blood and Urine and the Fetal Circulation in Pre-eclampsia. Int J Mol Sci 2023; 24:3579. [PMID: 36834991 PMCID: PMC9958563 DOI: 10.3390/ijms24043579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
Trace elements such as selenium and zinc are vital components of many enzymes, including endogenous antioxidants, and can interact with each other. Women with pre-eclampsia, the hypertensive disease of pregnancy, have been reported as having changes in some individual antioxidant trace elements during pregnancy, which are related to maternal and fetal mortality and morbidity. We hypothesised that examination of the three compartments of (a) maternal plasma and urine, (b) placental tissue and (c) fetal plasma in normotensive and hypertensive pregnant women would allow identification of biologically significant changes and interactions in selenium, zinc, manganese and copper. Furthermore, these would be related to changes in the angiogenic markers, placental growth factor (PlGF) and Soluble Fms-Like Tyrosine Kinase-1 (sFlt-1) concentrations. Venous plasma and urine were collected from healthy non-pregnant women (n = 30), normotensive pregnant controls (n = 60) and women with pre-eclampsia (n = 50) in the third trimester. Where possible, matched placental tissue samples and umbilical venous (fetal) plasma were also collected. Antioxidant micronutrient concentrations were measured by inductively coupled plasma mass-spectrometry. Urinary levels were normalised to creatinine concentration. Plasma active PlGF and sFlt-1 concentrations were measured by ELISA. Maternal plasma selenium, zinc and manganese were all lower in women with pre-eclampsia (p < 0.05), as were fetal plasma selenium and manganese (p < 0.05 for all); maternal urinary concentrations were lower for selenium and zinc (p < 0.05). Conversely, maternal and fetal plasma and urinary copper concentrations were higher in women with pre-eclampsia (p < 0.05). Differences in placental concentrations varied, with lower overall levels of selenium and zinc (p < 0.05) in women with pre-eclampsia. Maternal and fetal PlGF were lower and sFlt-1 higher in women with pre-eclampsia; maternal plasma zinc was positively correlated with maternal plasma sFlt-1 (p < 0.05). Because of perceptions that early- and late-onset pre-eclampsia have differing aetiologies, we subdivided maternal and fetal data accordingly. No major differences were observed, but fetal sample sizes were small following early-onset. Disruption in these antioxidant micronutrients may be responsible for some of the manifestations of pre-eclampsia, including contributing to an antiangiogenic state. The potential benefits of mineral supplementation, in women with deficient intakes, during pregnancy to reduce pre-eclampsia remain an important area for experimental and clinical research.
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Affiliation(s)
- Lesia O. Kurlak
- School of Medicine (Stroke Research), University of Nottingham, Nottingham NG7 2UH, UK
| | - Paula J. Scaife
- Clinical, Metabolic and Molecular Physiology Research Group, University of Nottingham, Derby DE22 3DT, UK
| | - Louise V. Briggs
- School of Engineering, University of Nottingham, Nottingham NG7 2RD, UK
| | - Fiona Broughton Pipkin
- Department of Obstetrics & Gynaecology, University of Nottingham, Nottingham NG5 1PB, UK
| | - David S. Gardner
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK
| | - Hiten D. Mistry
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, London SE1 1UL, UK
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Traffic Noise and Ambient Air Pollution Are Risk Factorsfor Preeclampsia. J Clin Med 2022; 11:jcm11154552. [PMID: 35956166 PMCID: PMC9369709 DOI: 10.3390/jcm11154552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/20/2022] [Accepted: 08/03/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose: We aimed to evaluate the effect of traffic-related noise (TRN), environmental noise (EN) and traffic-related air pollution (TRAP) on preeclampsia. Methods: We followed 285 pregnant women from Maternal and Child Health Clinics who reported exposure to TRN on a scale from 0 (absence of EN) to 10 (high level of EN). EN was measured using a portable dosimeter, and NOx was calculated using the AERMOD pollutant dispersion model. Results: Using a multiple logistic regression model, adjusted for maternal age, BMI, number of births, fetal sex and maternal chronic illness, TRN (score ≥ 6 vs. score < 6) and TRAP (NOx ≥ 300 µ/m3 vs. NOx < 300 µ/m3) were noted as independent risk factors for preeclampsia, with OR = 3.07 (95% CI 0.97; 9.70, p = 0.056) and OR = 3.43 (95% CI 1.20; 9.87, p = 0.022), respectively. Joint exposure to TRN and TRAP was associated with a significant and independent risk for preeclampsia (OR of 4.11 (95% CI 1.31; 12.94, p = 0.016). Conclusions: In our population, traffic-related noise and ambient TRAP were risk factors for preeclampsia.
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Role of zinc in neonatal growth and brain growth: review and scoping review. Pediatr Res 2021; 89:1627-1640. [PMID: 33010794 DOI: 10.1038/s41390-020-01181-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022]
Abstract
This manuscript includes (1) a narrative review of Zinc as an essential nutrient for fetal and neonatal growth and brain growth and development and (2) a scoping review of studies assessing the effects of Zinc supplementation on survival, growth, brain growth, and neurodevelopment in neonates. Very preterm infants and small for gestational age infants are at risk for Zinc deficiency. Zinc deficiency can cause several complications including periorificial lesions, delayed wound healing, hair loss, diarrhea, immune deficiency, growth failure with stunting, and brain atrophy and dysfunction. Zinc is considered essential for oligodendrogenesis, neurogenesis, neuronal differentiation, white matter growth, and multiple biological and physiological roles in neurobiology. Data support the possibility that the critical period of Zinc delivery for brain growth in the mouse starts at 18 days of a 20-21-day pregnancy and extends during lactation and in human may start at 26 weeks of gestation and extend until at least 44 weeks of postmenstrual age. Studies are needed to better elucidate Zinc requirement in extremely low gestational age neonates to minimize morbidity, optimize growth, and brain growth, prevent periventricular leukomalacia and optimize neurodevelopment. IMPACT: Zinc is essential for growth and brain growth and development. In the USA, very preterm small for gestational age infants are at risk for Zinc deficiency. Data support the possibility that the critical period of Zinc delivery for brain growth in the mouse starts at 18 days of a 20-21-day pregnancy and extends during lactation and in human may start at 26 weeks' gestation and extend until at least 44 weeks of postmenstrual age. Several randomized trials of Zinc supplementation in neonates have shown improvement in growth when using high enough dose, for long duration in patients likely to or proven to have a Zinc deficiency. Studies are needed to better elucidate Zinc requirement in extremely low gestational age neonates to minimize morbidity, optimize growth and brain growth, prevent periventricular leukomalacia and optimize neurodevelopment.
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Al-Sakarneh NA, Mashal RH. Evaluation of Zinc and Homocysteine Status in Pregnant Women and Their Association with Pre-eclampsia in Jordan. Prev Nutr Food Sci 2021; 26:21-29. [PMID: 33859956 PMCID: PMC8027045 DOI: 10.3746/pnf.2021.26.1.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 11/23/2022] Open
Abstract
Pre-eclampsia (PE) is considered a major complication of pregnancy. Hyperhomocyteinemia (H-Hcy) has been proposed to be associated with a number of placenta-mediated diseases, such as PE. Zinc (Zn) is involved in the regulation of total homocysteine (Hcy) levels. A case-control study design was used to examine serum Zn and Hcy statuses, and their association to PE risk. Thirty pregnant women with PE 21∼35 years of age, and 30 matched healthy pregnant women were recruited from Amman, Jordan. Plasma Hcy was measured using liquid chromatography-mass spectrometry, and Zn was measured using atomic absorption. Hcy levels were significantly higher among women with PE compared with controls (16.35±0.43 and 7.25±0.21 μmol/L, respectively; P<0.05). However, there was no significant difference in Zn levels between women with PE and controls (65.37±1.27 and 63.71±1.24 μg/dL, respectively; P>0.05). Blood levels of Hcy (μmol/L) were positively associated with systolic and diastolic blood pressure (β=3.54 and β=1.81, respectively; P<0.05), and Zn levels [odds ratios (OR)=0.84; 95% confidence intervals (CI): 0.71∼0.98] were significantly associated with PE risk (P<0.05). Although women with PE had significantly higher Hcy levels than controls, H-Hcy was not associated with increased PE risk. However, there was a strong association between severity of hypertension and serum Hcy levels, and serum Zn levels were inversely associated with H-Hcy. The likelihood of PE was significantly higher in women who were Zn deficient compared with healthy controls. To conclude, early management of H-Hcy and associated risk factors may be effective in decreasing the incidence of PE.
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Affiliation(s)
- Nawal Ahmad Al-Sakarneh
- Food Physical Laboratory Division, Administration Laboratories Directoraite, Jordan Food and Drug Administration (JFDA), Amman 11942, Jordan.,Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan
| | - Rima Hussein Mashal
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan
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Eze SC, Ododo NA, Ugwu EO, Enebe JT, Onyegbule OA, Eze IO, Ezem BU. Serum selenium levels of pre-eclamptic and normal pregnant women in Nigeria: A comparative study. PLoS One 2020; 15:e0238263. [PMID: 32853288 PMCID: PMC7451566 DOI: 10.1371/journal.pone.0238263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/12/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Trace element selenium, an antioxidant, and peroxynitrite scavenger when incorporated into selenoproteins and enzymes reduce oxidative stress which is implicated in the aetiopathogenesis of pre-eclampsia. A paucity of information exists on the serum selenium levels among pre-eclamptic pregnant women in Nigeria, hence the need for this study. OBJECTIVE To compare mean serum selenium levels and prevalence of selenium deficiency in preeclamptic pregnant women and their normotensive pregnant controls. MATERIALS AND METHODS A comparative case-control study was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo state. Fifty-eight preeclamptic and equal normotensive pregnant controls were matched for age groups, gestational age groups, parity groups, and socio-economic status had their serum samples analyzed for selenium level using atomic absorption spectrophotometer (ASS). Data analysis was done using the statistical package for social sciences (SPSS) version 20.0. P-value of < 0.05 was considered to be statistically significant. RESULT Mean serum selenium levels of the preeclamptic women(0.67±0.27μmol/l) was significantly (p<0.001) lower than that of the normotensive controls(1.20±0.46μmol/l). Selenium deficiency occurred significantly more in preeclamptic women (33(56.9%) than normotensive women (10(17.2%). Pearson's coefficient analysis showed negative correlation between serum selenium level with severity of systolic blood pressure (Correlation Coefficient (r) = -0.593), diastolic blood pressure(r = -0.519) and severity of preeclampsia(r = -0.598). CONCLUSION Serum selenium levels of pre-eclamptic women were significantly lower compared to that of normotensive pregnant controls and selenium deficiency occurred significantly more among the preeclamptic pregnant women compared to the normotensive controls. Selenium level dynamics in pregnancy possibly could play a role in the incidence of pre-eclampsia among pregnant women.
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Affiliation(s)
- Stephen Chijioke Eze
- Department of Obstetrics & Gynaecology, Federal Medical Centre (FMC), Owerri, Nigeria
| | - Nathan Azubuike Ododo
- Department of Obstetrics & Gynaecology, Federal Medical Centre (FMC), Owerri, Nigeria
| | - Emmanuel Onyebuchi Ugwu
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Joseph Tochukwu Enebe
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology College of Medicine/Teaching Hospital, Parklane, Enugu, Nigeria
| | | | - Innocent Okafor Eze
- Department of Obstetrics & Gynaecology, Federal Medical Centre (FMC), Owerri, Nigeria
| | - Bamidele Uche Ezem
- Departments of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, Imo State University, Orlu, Imo State, Nigeria
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Akdas S, Yazihan N. Cord blood zinc status effects on pregnancy outcomes and its relation with maternal serum zinc levels: a systematic review and meta-analysis. World J Pediatr 2020; 16:366-376. [PMID: 31446568 DOI: 10.1007/s12519-019-00305-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/06/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND The association between maternal and cord blood zinc level and pregnancy outcomes remains uncertain. The present study aims to assess whether maternal blood zinc level represents cord blood zinc level correctly. METHODS In this meta-analysis, systematic search was performed in PubMed, Web of Science, and Scopus databases for relevant available English articles which included mean and standard deviation values of cord blood zinc level up to April 2019. For the assessment of the relation between cord blood zinc level and pregnancy outcomes, the pooled standard mean difference with 95% confidence interval (CI) was used and 23 studies were analyzed. RESULTS Cumulative analysis showed that cord blood zinc level was found significantly decreased in pregnancies with complications compared with healthy pregnancy controls [REM: P = 0.0007, mean difference - 7.9 (- 12.48, - 3.31)]. For further analysis, maternal serum zinc level status was determined from same studies to compare with cord blood levels and subgroups were detected as "Preterm", "Preeclampsia", "Small for gestational age/Intrauterine growth restriction and Low birth weight". It was observed that cord blood zinc levels in subgroup analysis were also decreased and/or tend to be decreased compared to healthy pregnancies, except for preeclampsia subgroup. Also, a correlation was seen between cord blood and maternal blood zinc level status (R = 0.4365, 95% CI - 0.530, 0.756; P = 0.0351). CONCLUSION It was thought that cord blood zinc level might tend to decrease more than maternal serum zinc level in the pathological conditions during pregnancies.
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Affiliation(s)
- Sevginur Akdas
- Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Institute of Health Sciences, Ankara University, Ankara, Turkey
| | - Nuray Yazihan
- Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Institute of Health Sciences, Ankara University, Ankara, Turkey. .,Department of Pathophysiology, Internal Medicine Division, Faculty of Medicine, Ankara University, Ankara, Turkey.
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Enebe JT, Dim CC, Ugwu EO, Enebe NO, Meka IA, Obioha KC, Eleje GU, Nwagha UI. Serum antioxidant micronutrient levels in pre-eclamptic pregnant women in Enugu, south-East Nigeria: a comparative cross-sectional analytical study. BMC Pregnancy Childbirth 2020; 20:392. [PMID: 32631273 PMCID: PMC7339396 DOI: 10.1186/s12884-020-03081-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/29/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Pre-eclampsia is a common obstetric complication of pregnancy in Nigeria, and oxidative stress has been implicated in its aetiopathogenesis. Despite this fact, there is a paucity of information regarding the serum antioxidant micronutrient status of pre-eclamptic Nigerian women. The objective of the was to determine the mean serum levels of some antioxidant trace elements (copper, zinc, selenium, magnesium, manganese) in pre-eclamptic pregnant women and compare with that of healthy pregnant women in Enugu, South-Eastern, Nigeria. METHODS A cross-sectional analytical study was carried out at the Obstetrics and Gynaecology department of the University of Nigeria, Teaching Hospital Ituku-Ozalla, Enugu. Using atomic absorption spectrophotometry, the sera of 81 pregnant pre-eclamptic and 81 matched healthy pregnant controls were analyzed for the antioxidant micronutrients. Both descriptive and inferential analysis was performed using the statistical package for social sciences (SPSS) version 21.0 and a P value of < 0.05 was considered to be statistically significant. RESULTS The mean serum levels of copper, selenium, and magnesium were found to be significantly lower in the pre-eclamptic pregnant group when compared to the healthy pregnant controls (p < 0.05). The mean serum levels of zinc and manganese did not differ between the two groups (p > 0.05). All the mean serum levels of micro-nutrients studied did not vary by category of pre-eclampsia (with or without severity findings) except manganese which was significantly lower in pre-eclamptic women without severity findings when compared to those with severity findings (p = 0.043). CONCLUSIONS The serum levels of copper, selenium, and magnesium were significantly lower among pre-eclamptics when compared to their normal healthy controls. Low levels of selenium, copper, and magnesium may have contributed to the incidence of pre-eclampsia in our environment.
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Affiliation(s)
- Joseph Tochukwu Enebe
- Department of Obstetrics & Gynaecoclogy, Enugu State University of Science and Technology College of Medicine/Teaching Hospital, Parklane, P.M.B. 1030, Enugu, 400001, Nigeria.
| | - Cyril Chukwudi Dim
- Departments of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
- Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
| | - Emmanuel Onyebuchi Ugwu
- Departments of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
- Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
| | | | - Ijeoma Angela Meka
- Department of Chemical Pathology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Kingsley Chukwu Obioha
- Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
| | - George Uchenna Eleje
- Effective Care Research Unit, Departments of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
| | - Uchenna Ifeanyi Nwagha
- Departments of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
- Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Nsukka, Nigeria
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Gajewska K, Błażewicz A, Laskowska M, Niziński P, Dymara-Konopka W, Komsta Ł. Chemical elements and preeclampsia - An overview of current problems, challenges and significance of recent research. J Trace Elem Med Biol 2020; 59:126468. [PMID: 32007824 DOI: 10.1016/j.jtemb.2020.126468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 12/04/2019] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Data on the elemental status, redistribution of the elements, role of occupational exposure and dietary assessment in preeclampsia (PE) are scarce. There are many disparities in the findings of essential and non-essential elements' role in PE. In this article we overview the changes in the content of selected elements in pregnancy complicated with the disorder of complex and not fully understood etiology. We have focused on important limitations and highlighted shortcomings in research from the last ten years period. METHODS The Scopus and PubMed electronic databases have been searched for English-language articles published within the time interval 2008-2018, with full text available and with the key words "preeclampsia" and "chemical element" (i.e. separately: Cd, Pb, As, Ni, Mo, Co, Cr, Mn, Se, I, Fe, Sr, Cu, Zn, Mg, K and Na) appearing in the title, abstract or keywords. RESULTS A total of 48 publications were eligible for this overview. Surprisingly only 4% of papers considered environmental exposure, 8%- diet and 2 %- comorbid diseases. In most published papers, occupational exposure was neglected. Meta-analysis was possible for seven elements in serum (Ca, Cu, Fe, Mg, Mn, Se, Zn), and two elements (Se, Zn) in plasma. It showed negative shift for most elements, however only several were statistically significant. CONLUSIONS The overview of the published data on PE and chemical elements yields varied results. Some of the reasons may be the difference in not duly validated method of determination, and huge discrepancies in study designs. The lack of detailed description of studied and control population and small number of samples constitute the most common limitations of such studies. Many of them describe the use of a single analytical procedure, therefore the quality of research may be insufficient to obtain reliable results. A history of elements' status and intake before and during pregnancy is usually not examined. Dietary assessment should be done at different stages of pregnancy, and whenever possible in the periconceptional period as well. It still needs to be established whether the deficiency of certain elements or their excess may be an etiopathogenic factor and a developmental cause of PE, and if it may serve as a target of actions in the causal treatment or even prevention of the occurrence of this disease.
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Affiliation(s)
- Katarzyna Gajewska
- Chair of Chemistry, Department of Analytical Chemistry, Medical University of Lublin, Poland.
| | - Anna Błażewicz
- Chair of Chemistry, Department of Analytical Chemistry, Medical University of Lublin, Poland
| | - Marzena Laskowska
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Przemysław Niziński
- Chair of Chemistry, Department of Analytical Chemistry, Medical University of Lublin, Poland
| | | | - Łukasz Komsta
- Department of Medicinal Chemistry, Faculty of Pharmacy with Division of Medical Analytics, Medical University of Lublin, Poland
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11
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Espart A, Artime S, Tort-Nasarre G, Yara-Varón E. Cadmium exposure during pregnancy and lactation: materno-fetal and newborn repercussions of Cd(ii), and Cd-metallothionein complexes. Metallomics 2019; 10:1359-1367. [PMID: 30221266 DOI: 10.1039/c8mt00174j] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cadmium (Cd) is a non-physiological heavy metal that can be harmful at low concentrations. Increasing anthropogenic activities are incrementing the risk of accumulation of this heavy metal in different organs and tissues of the body. In the case of pregnant women, the threat is more serious due to the implications affecting not only their own health but also fetal development as well. Metallothioneins (MTs), small cysteine-rich proteins, are involved in zinc (Zn) and copper homeostasis in mammals but can, however, also bind with Cd if present. The accumulation of Cd in maternal tissues (e.g. placenta, maternal blood, and mammary glands) induces the synthesis of MTs, preferably MT2, in an attempt to sequester the metal to avoid toxicity. The formed Cd-MT complexes will avoid the Cd transport from the placenta to the fetus and end up accumulating in the maternal kidneys. At the same time, high concentrations of MTs will increase the formation of Zn-MT complexes, therefore decreasing the amount of Zn ions available to be transported to the fetus by means of Zn transporters such as ZnT2, ZIP14 and DMT1. Although MTs cannot transport Cd from the mother to the fetus, the divalent DMT1 transporter is suggested to carry the metal to the fetus. As a consequence, the low levels of Zn(ii) in the fetus, together with the presence of Cd(ii) coming from the mother either via the placenta and cord blood or via breast milk induce changes in the fetal development including fetal growth retardation, and low weight or height of the newborn. Likewise, the concentrations of Cd(ii) in the newborn can cause alterations such as cognitive disabilities. In summary, the presence of Cd(ii) in the maternal tissues will induce MT synthesis in an attempt to detoxify these tissues and reduce the possible toxicity of Cd in fetal and newborn tissues.
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Affiliation(s)
- Anna Espart
- Department of Nursing and Physiotherapy, University of Lleida, c. Montserrat Roig 2, Lleida, E-25198, Spain. and Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr PifarréFoundation, IRBLleida, Av. Alcalde Rovira Roure 80, Lleida, E-25198, Spain
| | - Sebastián Artime
- Departament de Genètica, Microbiologia i Estadística and Institut de Recerca de la Biodiversitat (IRBio), University of Barcelona, Av. Diagonal 643, E-08028 Barcelona, Spain
| | - Glòria Tort-Nasarre
- Department of Nursing and Physiotherapy, University of Lleida, c. Montserrat Roig 2, Lleida, E-25198, Spain.
| | - Edinson Yara-Varón
- Department of Chemistry, University of Lleida, Av. Alcalde Rovira Roure 191, E-25198 Lleida, Spain
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Lewandowska M, Sajdak S, Lubiński J. Serum Selenium Level in Early Healthy Pregnancy as a Risk Marker of Pregnancy Induced Hypertension. Nutrients 2019; 11:nu11051028. [PMID: 31071931 PMCID: PMC6566672 DOI: 10.3390/nu11051028] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 01/06/2023] Open
Abstract
Selenium (Se) is an antioxidant nutrient whose deficiency can influence adverse outcomes of pregnancy. The aim of this study is to determine whether serum Se level in early healthy pregnancy may be a risk marker for pregnancy induced hypertension. We obtained data from our prospective study in which we recruited healthy women in weeks 10–14 of a single pregnancy. In this analysis, we examined 121 women who subsequently developed pregnancy-induced hypertension and matched 363 women who remained normotensive. We measured Se levels (using the ICP-MS technique) in the serum in weeks 10–14 of the pregnancy. The odds ratios of pregnancy-induced hypertension (95% confidence intervals) were calculated using multivariate logistic regression. We found that the mean Se level was lower in the case group compared to the control (57.51 vs. 62.89 μg/L; p = 2.6 × 10−10). Excessive body mass index (BMI) and smoking influenced the estimated odds ratios. In the subgroup of women who had never smoked with normal pre-pregnancy BMI, the adjusted odds ratio (AOR) of pregnancy-induced hypertension was 15.34 (95% CI: 2.73–86.31, p = 0.002) for Se levels in the lowest quartile (≤57.68 µg/L), as compared to the highest quartile (>66.60 µg/L), after adjusting for all the accepted confounders. In the whole cohort, the prognostic value of Se by logistic regression showed that the area under curve (AUC) = 0.814. In our study, one can consider the role of Se as a risk marker of pregnancy-induced hypertension.
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Affiliation(s)
- Małgorzata Lewandowska
- Division of Gynecological Surgery, Poznań University of Medical Sciences, 60-535 Poznań, Poland.
| | - Stefan Sajdak
- Division of Gynecological Surgery, Poznań University of Medical Sciences, 60-535 Poznań, Poland.
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, 71-252 Szczecin, Poland.
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Marshall SA, Cox AG, Parry LJ, Wallace EM. Targeting the vascular dysfunction: Potential treatments for preeclampsia. Microcirculation 2018; 26:e12522. [PMID: 30556222 DOI: 10.1111/micc.12522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/22/2018] [Accepted: 12/10/2018] [Indexed: 12/18/2022]
Abstract
Preeclampsia is a pregnancy-specific disorder, primarily characterized by new-onset hypertension in combination with a variety of other maternal or fetal signs. The pathophysiological mechanisms underlying the disease are still not entirely clear. Systemic maternal vascular dysfunction underlies the clinical features of preeclampsia. It is a result of oxidative stress and the actions of excessive anti-angiogenic factors, such as soluble fms-like tyrosine kinase, soluble endoglin, and activin A, released by a dysfunctional placenta. The vascular dysfunction then leads to impaired regulation and secretion of relaxation factors and an increase in sensitivity/production of constrictors. This results in a more constricted vasculature rather than the relaxed vasodilated state associated with normal pregnancy. Currently, the only effective "treatment" for preeclampsia is delivery of the placenta and therefore the baby. Often, this means a preterm delivery to save the life of the mother, with all the attendant risks and burdens associated with fetal prematurity. To lessen this burden, there is a pressing need for more effective treatments that target the maternal vascular dysfunction that underlies the hypertension. This review details the vascular effects of key drugs undergoing clinical assessment as potential treatments for women with preeclampsia.
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Affiliation(s)
- Sarah A Marshall
- Departments of Obstetrics and Gynaecology and Medicine, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Victoria, Australia
| | - Annie G Cox
- Departments of Obstetrics and Gynaecology and Medicine, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Victoria, Australia
| | - Laura J Parry
- School of BioSciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Euan M Wallace
- Departments of Obstetrics and Gynaecology and Medicine, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Victoria, Australia
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Abstract
Selenium (Se) is an essential trace element of significant importance in human health. Diet is the major source of Se, and intake of this element depends on its concentration in food sources as well as the amount of those sources consumed. Unfortunately, daily dietary intake of Se in most European countries is generally low, ∼30-40μg/day, compared with the recommended dietary allowance, ∼55 and 70μg/day for adult females and males, respectively. The importance of Se as an essential trace element is linked to its role as selenocysteine in a number of selenoproteins including antioxidant enzymes glutathione peroxidases (GSH-Pxs), thioredoxin reductases (TrxRs), and selenoprotein P (SePP). These enzymes protect tissues against the damaging effect of reactive oxygen species (ROS) and other endogenous products of cellular metabolism implicated in DNA damage and potentially leading to mutagenesis, cell death, and carcinogenesis. Reduced body Se and antioxidant enzyme activity during pregnancy results in oxidative stress within tissues contributing to premature birth, miscarriage, preeclampsia, and intrauterine growth retardation. Because placenta development is highly dependent on oxygen status, uncontrolled ROS formation is likely detrimental. Despite these findings, the role of Se and Se-dependent enzymes in pregnancy remains controversial. The objective of this review is to explore Se status in pregnancy with respect to adverse outcomes. Effects related to decreased antioxidant activity and increased oxidative stress will be highlighted.
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Affiliation(s)
- Bronislaw A Zachara
- Department of Cosmetology and Physiotherapy, Higher School of Health Sciences, Bydgoszcz, Poland.
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15
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Rigo J, Pieltain C, Christmann V, Bonsante F, Moltu SJ, Iacobelli S, Marret S. Serum Magnesium Levels in Preterm Infants Are Higher Than Adult Levels: A Systematic Literature Review and Meta-Analysis. Nutrients 2017; 9:nu9101125. [PMID: 29035309 PMCID: PMC5691741 DOI: 10.3390/nu9101125] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/06/2017] [Accepted: 10/07/2017] [Indexed: 12/20/2022] Open
Abstract
Magnesium (Mg) is an essential mineral in the body, impacting the synthesis of biomacromolecules, bone matrix development, energy production, as well as heart, nerve, and muscle function. Although the importance of Mg is evident, reference values for serum Mg (sMg) in pediatric patients (more specifically, in neonates) are not well established. This systematic literature review and meta-analysis (using 47 eligible studies) aims to quantify normal and tolerable ranges of sMg concentrations during the neonatal period and to highlight the factors influencing Mg levels and the importance of regulating sMg levels during pregnancy and birth. In newborns without Mg supplementation during pregnancy, magnesium levels at birth (0.76 (95% CI: 0.52, 0.99) mmol/L) were similar to that of mothers during pregnancy (0.74 (95% CI: 0.43, 1.04) mmol/L), but increased during the first week of life (0.91 (95% CI: 0.55, 1.26) mmol/L) before returning to adult levels. This pattern was also seen in newborns with Mg supplementation during pregnancy, where the average was 1.29 (95% CI: 0.50, 2.08) mmol/L at birth and 1.44 (95% CI: 0.61, 2.27) mmol/L during the first week of life. Factors influencing these levels include prenatal Mg supplementation, gestational age, birth weight, renal maturity/function, and postnatal Mg intake. Elevated Mg levels (>2.5 mmol/L) have been associated with an increased risk of mortality, admission into intensive care, hypotonia, hypotension, and respiratory depression but sMg concentrations up to 2.0 mmol/L appear to be well tolerated in neonates, requiring adequate survey and minimal intervention.
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Affiliation(s)
- Jacques Rigo
- Department of Neonatology, Université de Liège, CHR Citadelle, 4000 Liège, Belgium.
| | - Catherine Pieltain
- Department of Neonatology, Université de Liège, CHR Citadelle, 4000 Liège, Belgium.
| | - Viola Christmann
- Radboudumc Amalia Children's Hospital, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
| | - Francesco Bonsante
- Centre d'Etudes Périnatales de l'Océan Indien (EA 7388), CHU La Réunion-Site Sud Saint Pierre, BP 350 97448 Saint Pierre CEDEX, France.
- Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion-Site Sud Saint Pierre, BP 350 97448 Saint Pierre CEDEX, France.
| | - Sissel J Moltu
- Department of Neonatal Intensive Care, Oslo University Hospital, 0318 Oslo, Norway.
| | - Silvia Iacobelli
- Centre d'Etudes Périnatales de l'Océan Indien (EA 7388), CHU La Réunion-Site Sud Saint Pierre, BP 350 97448 Saint Pierre CEDEX, France.
- Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion-Site Sud Saint Pierre, BP 350 97448 Saint Pierre CEDEX, France.
| | - Stéphane Marret
- Department of Neonatal Pediatrics and Intensive Care and Neuropediatrics, Rouen University Hospital, and INSERM, Laboratoire NeoVasc ERI28, Normandy University, 76000 Rouen, France.
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16
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Maduray K, Moodley J, Soobramoney C, Moodley R, Naicker T. Elemental analysis of serum and hair from pre-eclamptic South African women. J Trace Elem Med Biol 2017; 43:180-186. [PMID: 28325649 DOI: 10.1016/j.jtemb.2017.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/26/2017] [Accepted: 03/02/2017] [Indexed: 01/08/2023]
Abstract
Pre-eclampsia is a hypertensive disorder that is associated with adverse maternal and perinatal outcomes. It has been proposed that specific trace and macro elements associated with antioxidant activities may also play a contributory role in aetiology of pre-eclampsia. The aim of this study was to measure the concentrations of thirteen different elements in hair and serum samples from women with a diagnosis of pre-eclampsia and compare them with normotensive controls. Venous blood and pubic hair samples were collected from forty-three pre-eclamptic and twenty-three normotensive pregnant women. In each sample, the concentration of arsenic (As); calcium (Ca); cadmium (Cd); chromium (Cr); cobalt (Co); magnesium (Mg); manganese (Mn); iron (Fe); copper (Cu); lead (Pb); selenium (Se); nickel (Ni); zinc (Zn) were measured using inductively coupled plasma-optical emission spectrometry. Cobalt concentration in hair was significantly lower in the pre-eclampsia group (1.56±0.74μg/g) compared to the normotensive group (2.89±4.99μg/g) (p=0.02). The concentrations of Zn and Cr were significantly higher in hair samples from the pre-eclamptic group, compared to the normotensive control group (Zn, 395.99±48.60 vs 330.88±29.70μg/g; Cr, 13.31±2.67 vs 11.05±7.62μg/g: p≤0.05). There were no significant differences in the hair levels of other elements between groups. Serum Zn was significantly higher in the pre-eclamptic group (0.16-253.4mg/L) compared to the normotensive group (0.2-48.4mg/L) (p=0.01). Serum Ca, Co, Cu, Mg, Mn and Se levels were found to be significantly lower in the pre-eclamptic group compared to the normotensive group (p<0.05). This study confirms the association between pre-eclampsia and maternal trace as well as macro element levels.
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Affiliation(s)
- K Maduray
- Optics and Imaging Centre, University of KwaZulu-Natal, South Africa.
| | - J Moodley
- Womens' Health and HIV Research Group, University of KwaZulu-Natal, South Africa
| | - C Soobramoney
- Optics and Imaging Centre, University of KwaZulu-Natal, South Africa
| | - R Moodley
- Department of Chemistry, University of KwaZulu-Natal, South Africa
| | - T Naicker
- Optics and Imaging Centre, University of KwaZulu-Natal, South Africa
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Elmugabil A, Hamdan HZ, Elsheikh AE, Rayis DA, Adam I, Gasim GI. Serum Calcium, Magnesium, Zinc and Copper Levels in Sudanese Women with Preeclampsia. PLoS One 2016; 11:e0167495. [PMID: 27911936 PMCID: PMC5135106 DOI: 10.1371/journal.pone.0167495] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/15/2016] [Indexed: 01/24/2023] Open
Abstract
Background Although the exact pathophysiology of preeclampsia is not fully understood, several elemental micronutrient abnormalities have been suggested to play a contributory role in preeclampsia. Aims To investigate the levels of calcium, magnesium, zinc and copper in women with preeclampsia. Subjects and Methods A case—control study was conducted in Omdurman Maternity Hospital, Sudan, during the period of September through December 2014. The cases were women with preeclampsia while healthy pregnant women were the controls. The medical and obstetrics history was gathered using questionnaires. The serum levels of calcium, magnesium, zinc and copper were measured using atomic absorption spectrophotometer. Results There was no significant difference between the two groups in their age, gestational age, parity and body mass index. Zinc and copper levels were not significantly different between the two groups. In comparison with the controls, women with preeclampsia had a significantly lower median (inter-quartile) serum calcium [7.6 (4.0─9.6) vs. 8.1 (10.6─14.2), mg/dl, P = 0.032] and higher levels of magnesium [1.9 (1.4─2.5) vs. 1.4 (1.0─1.9) mg/dl; P = 0.003]. In binary logistic regression, lower calcium (OR = 0.73, 95% CI = 0.56 ─ 0.95, P = 0.021) and higher magnesium (OR = 5.724, 95% CI = 1.23 ─ 26.50, P = 0.026) levels were associated with preeclampsia. There were no significant correlations between levels of hemoglobin and these trace elements. Conclusion The current study showed significant associations between preeclampsia and serum levels of calcium and magnesium.
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Affiliation(s)
| | | | | | - Duria A. Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- * E-mail:
| | - Gasim I. Gasim
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
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Wilson RL, Grieger JA, Bianco-Miotto T, Roberts CT. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review. Nutrients 2016; 8:E641. [PMID: 27754451 PMCID: PMC5084028 DOI: 10.3390/nu8100641] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 12/12/2022] Open
Abstract
Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE); spontaneous preterm birth (sPTB); low birthweight (LBW); and gestational diabetes (GDM). Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed. In 10 out of 16 studies a difference was reported with respect to circulating zinc between women who gave birth to a LBW infant (≤2500 g) and those who gave birth to an infant of adequate weight (>2500 g), particularly in populations where inadequate zinc intake is prevalent. In 16 of our 33 studies an association was found between hypertensive disorders of pregnancy and circulating zinc; particularly in women with severe PE (blood pressure ≥160/110 mmHg). No association between maternal zinc status and sPTB or GDM was seen; however; direct comparisons between the studies was difficult. Furthermore; only a small number of studies were based on women from populations where there is a high risk of zinc deficiency. Therefore; the link between maternal zinc status and pregnancy success in these populations cannot be established. Future studies should focus on those vulnerable to zinc deficiency and include dietary zinc intake as a measure of zinc status.
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Affiliation(s)
- Rebecca L Wilson
- Robinson Research Institute, University of Adelaide, Adelaide SA 5005, Australia.
- Adelaide Medical School, University of Adelaide, Adelaide SA 5005, Australia.
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, Adelaide SA 5005, Australia.
- Adelaide Medical School, University of Adelaide, Adelaide SA 5005, Australia.
| | - Tina Bianco-Miotto
- Robinson Research Institute, University of Adelaide, Adelaide SA 5005, Australia.
- Waite Research Institute, School of Agriculture, Food and Wine, University of Adelaide, Adelaide SA 5005, Australia.
| | - Claire T Roberts
- Robinson Research Institute, University of Adelaide, Adelaide SA 5005, Australia.
- Adelaide Medical School, University of Adelaide, Adelaide SA 5005, Australia.
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Xu M, Guo D, Gu H, Zhang L, Lv S. Selenium and Preeclampsia: a Systematic Review and Meta-analysis. Biol Trace Elem Res 2016; 171:283-292. [PMID: 26516080 DOI: 10.1007/s12011-015-0545-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/15/2015] [Indexed: 12/21/2022]
Abstract
Conflicting results exist between selenium concentration and preeclampsia. The role of selenium in the development of preeclampsia is unclear. We conducted a meta-analysis to compare the blood selenium level in patients with preeclampsia and healthy pregnant women, and to determine the effectiveness of selenium supplementation in preventing preeclampsia. We searched PubMed, ScienceDirect, the Cochrane Library, and relevant references for English language literature up to November 25, 2014. Mean difference from observational studies and relative risk from randomized controlled trials were meta-analyzed by a random-effect model. Thirteen observational studies with 1515 participants and 3 randomized controlled trials with 439 participants were included in the meta-analysis. Using a random-effect model, a statistically significant difference in blood selenium concentration of -6.47 μg/l (95 % confidence interval (CI) -11.24 to -1.7, p = 0.008) was seen after comparing the mean difference of observational studies. In randomized controlled trials, using a random-effect model, the relative risk for preeclampsia was 0.28 (0.09 to 0.84) for selenium supplementation (p = 0.02). Evidence from observational studies indicates an inverse association of blood selenium level and the risk of preeclampsia. Supplementation with selenium significantly reduces the incidence of preeclampsia. However, more prospective clinical trials are required to assess the association between selenium supplementation and preeclampsia and to determine the dose, beginning time, and duration of selenium supplementation.
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Affiliation(s)
- Min Xu
- Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Dan Guo
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hao Gu
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Shuyan Lv
- Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
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POLAT M, BİBEROĞLU EH, GÜLER İ, BİBEROĞLU ÖK. Coexistence of preeclampsia and inherited thrombophilia in Turkish pregnant women. Turk J Med Sci 2016; 46:1094-100. [DOI: 10.3906/sag-1502-132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 10/10/2015] [Indexed: 11/03/2022] Open
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The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis. Nutrients 2015; 7:7806-20. [PMID: 26389947 PMCID: PMC4586561 DOI: 10.3390/nu7095366] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 08/31/2015] [Accepted: 09/07/2015] [Indexed: 01/11/2023] Open
Abstract
The association between serum zinc level and preeclampsia (PE) remains controversial. A systematic literature search was performed in PubMed, Web of Science and Embase for relevant available articles. The articles were limited to those in English from January 1990 to April 2015. Observational studies evaluating the association between serum zinc level and PE were included. The I2 was used to assess heterogeneity and the random effect model (REM) was adopted as the pooling method. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to estimate the association between serum zinc level and PE. Seventeen observational studies were included. Compared with healthy pregnancy controls, PE patients have lower serum zinc level in 14 studies about total PE (SMD (95% CI): −0.587 (−0.963, −0.212), Z = 3.06, p for Z = 0.002; I2 = 88.4%, p for I2 < 0.0001). In subgroup analysis, a lower serum zinc level in PE patients compared with healthy pregnancy controls was observed in studies conducted in Asia, studies with zinc level measured in serum, and studies involving fasting participants. The SMD did not differ significantly between studies with healthy pregnancy controls matched by individual age (yes or no), and by individual gestational age (yes or no), respectively. Results from this meta-analysis indicate that serum zinc level in PE patients is significantly lower than that in healthy pregnancy controls. A moderate amount of zinc supplementation during pregnancy is advocated to reduce the incidence of PE.
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