Mahomed K, Williams M A, Woelk G B, Mudzamiri S, Madzime S, King I B, Bankson D D
Department of Obstetrics and Gynecology, University of Zimbabwe, School of Medicine, Harare.
Biol Trace Elem Res. 2000 Summer;75(1-3):107-18. doi: 10.1385/BTER:75:1-3:107.
Preeclampsia is an important cause of maternal and perinatal mortality worldwide. The etiology of this relatively common medical complication of pregnancy, however, remains unknown. We studied the relationship between maternal leukocyte selenium, zinc, and copper concentrations and the risk of preeclampsia in a large hospital-based case-control study. One hundred seventy-one women with proteinuric pregnancy-induced hypertension (with or without seizures) comprised the case group. Controls were 184 normotensive pregnant women. Leukocytes were separated from blood samples collected during the patients' postpartum labor and delivery admission. Leukocyte concentrations for the three cations were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Concentrations for each cation were reported as micrograms per gram of total protein. Women with preeclampsia had significantly higher median leukocyte selenium concentrations than normotensive controls (3.23 vs 2.80 microg/g total protein, p < 0.0001). Median leukocyte zinc concentrations were 31% higher in preeclamptics as compared with controls (179.15 vs 136.44 microg/g total protein, p < 0.0001). Although median leukocyte copper concentrations were slightly higher for cases than controls, this difference did not reach statistical significance (17.72 vs 17.00 microg/g total protein, p = 0.468). There was evidence of a linear increase in risk of preeclampsia with increasing concentrations of selenium and zinc. The relative risk for preeclampsia was 3.38 (adjusted odds ratio [OR] = 3.38, 95% confidence interval [CI] = 1.53-7.54) among women in the highest quartile of the control selenium distribution compared with women in the lowest quartile. The corresponding relative risk and 95% CI for preeclampsia was 5.30 (2.45-11.44) for women in the highest quartile of the control zinc distribution compared with women in the lowest quartile. There was no clear pattern of a linear trend in risk with increasing concentration of leukocyte copper concentrations (adjusted for linear trend in risk = 0.299). Our results are consistent with some previous reports. Prospective studies are needed to determine whether observed alterations in selenium and zinc concentrations precede preeclampsia or whether the differences may be attributed to preeclampsia-related alterations in maternal and fetal-placental trace metal metabolism.
子痫前期是全球孕产妇和围产期死亡的重要原因。然而，这种相对常见的妊娠医学并发症的病因仍不清楚。在一项大型的基于医院的病例对照研究中，我们研究了孕妇白细胞中硒、锌和铜的浓度与子痫前期风险之间的关系。171例患有蛋白尿性妊娠高血压（有或无惊厥）的妇女组成病例组。对照组为184例血压正常的孕妇。在患者产后分娩入院时采集血样，从中分离白细胞。通过电感耦合等离子体质谱法（ICP-MS）测定三种阳离子的白细胞浓度。每种阳离子的浓度以每克总蛋白微克数表示。子痫前期妇女的白细胞硒中位数浓度显著高于血压正常的对照组（3.23 vs 2.80微克/克总蛋白，p < 0.0001）。子痫前期患者的白细胞锌中位数浓度比对照组高31%（179.15 vs 136.44微克/克总蛋白，p < 0.0001）。虽然病例组的白细胞铜中位数浓度略高于对照组，但这种差异未达到统计学显著性（17.72 vs 17.00微克/克总蛋白，p = 0.468）。有证据表明，随着硒和锌浓度的增加，子痫前期的风险呈线性增加。与最低四分位数的妇女相比，对照组硒分布最高四分位数的妇女患子痫前期的相对风险为3.38（调整后的优势比[OR] = 3.38，95%置信区间[CI] = 1.53 - 7.54）。与最低四分位数的妇女相比，对照组锌分布最高四分位数的妇女患子痫前期的相应相对风险和95% CI为5.30（2.45 - 11.44）。随着白细胞铜浓度的增加，风险没有明显的线性趋势（风险线性趋势调整后 = 0.299）。我们的结果与之前的一些报告一致。需要进行前瞻性研究，以确定观察到的硒和锌浓度变化是先于子痫前期出现，还是这些差异可能归因于子痫前期相关的母婴和胎盘 - 胎儿微量金属代谢变化。
