Saarelainen Heli, Valtonen Pirjo, Punnonen Kari, Laitinen Tomi, Raitakari Olli T, Juonala Markus, Heiskanen Nonna, Lyyra-Laitinen Tiina, Viikari Jorma S A, Heinonen Seppo
Department of Obstetrics and Gynecology, Kuopio University Hospital, University of Kuopio, Puijonlaaksontie 2, PO box 1777, Kuopio FIN-70211, Finland.
Clin Physiol Funct Imaging. 2009 Sep;29(5):347-52. doi: 10.1111/j.1475-097X.2009.00877.x. Epub 2009 Jun 1.
Traditional risk factors such as hyperlipidemia induce a state of inflammation that impairs vascular function. Despite marked maternal hyperlipidemia, endothelial function improves during pregnancy. In non-pregnant state increased circulating levels of pro-inflammatory cytokines and high sensitive C-reactive protein (hsCRP) lead to attenuated flow mediated vasodilation. Relation between endothelial function and pro-inflammatory cytokines has not been studied thoroughly in pregnancy. The aim of this study was to evaluate the effect of pregnancy on hsCRP and pro-inflammatory cytokines and their associations with vascular endothelial function.
As part of population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland we measured brachial artery flow mediated dilation (FMD) and serum concentrations of hsCRP, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in 57 pregnant Finnish women throughout gestation and 62 control women matched for age and smoking.
HsCRP-concentration was greater in pregnancy compared to non-pregnant controls (median hsCRP 2.52 mg l(-1) versus 1.21 mg l(-1), P<0.001). IL-6-concentration was slightly increased in pregnancy compared with the non-pregnant controls (median 1.66 versus 1.32 mg l(-1), non-significant [NS]) and TNF-alpha-concentration was slightly decreased in pregnant group (2.11 versus 2.38 pg ml(-1), NS). FMD increased during pregnancy and IL-6 had a positive correlation to the FMD in pregnancy (R = 0.288, P = 0.031).
Improvement of FMD in normal pregnancy was not affected by increase in hsCRP concentration. We found an association with IL-6 and FMD but we believe that improvement in endothelial function during normal pregnancy is not caused by variation in hsCRP, IL-6 or TNF-alpha.
高脂血症等传统危险因素会引发炎症状态，损害血管功能。尽管孕妇存在明显的高脂血症，但孕期内皮功能却有所改善。在非孕期，促炎细胞因子和高敏C反应蛋白（hsCRP）循环水平升高会导致血流介导的血管舒张减弱。孕期内皮功能与促炎细胞因子之间的关系尚未得到充分研究。本研究的目的是评估孕期对hsCRP和促炎细胞因子的影响及其与血管内皮功能的关联。
作为在芬兰开展的基于人群的前瞻性队列“年轻芬兰人心血管风险研究”的一部分，我们在57名芬兰孕妇整个孕期以及62名年龄和吸烟情况相匹配的对照女性中测量了肱动脉血流介导的舒张功能（FMD）以及hsCRP、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的血清浓度。
与非孕期对照组相比，孕期hsCRP浓度更高（hsCRP中位数2.52 mg l⁻¹ 对1.21 mg l⁻¹，P<0.001）。与非孕期对照组相比，孕期IL-6浓度略有升高（中位数1.66对1.32 mg l⁻¹，无统计学意义[NS]），而孕期TNF-α浓度略有降低（2.11对2.38 pg ml⁻¹，NS）。孕期FMD增加，且孕期IL-6与FMD呈正相关（R = 0.288，P = 0.031）。
正常孕期FMD的改善不受hsCRP浓度升高的影响。我们发现IL-6与FMD有关联，但我们认为正常孕期内皮功能的改善并非由hsCRP、IL-6或TNF-α的变化所致。
