Beyazit Fatma, Türkön Hakan, Pek Eren, Ozturk Filiz Halici, Ünsal Mesut
a Department of Obstetrics and Gynecology , Canakkale Onsekiz Mart University , Canakkale , Turkey.
b Department of Biochemistry , Canakkale Onsekiz Mart University , Canakkale , Turkey.
J Obstet Gynaecol. 2018 Jul;38(5):668-673. doi: 10.1080/01443615.2017.1383371. Epub 2018 Feb 1.
Since the biochemical and molecular mechanisms responsible for ongoing oxidative stress in hyperemesis gravidarum (HEG) patients have not yet been fully elucidated, the aim of this study was to evaluate the possible role of nitric oxide (NO), malondialdehyde (MDA) and other oxidative stress markers in the disease pathophysiology. Moreover, the relation between oxidative stress markers and Helicobacter pylori (H. pylori) infection was also investigated. Women with pregnancies complicated by HEG (n = 33) were compared with pregnant women without HEG (n = 30) and with healthy non-pregnant women (n = 31). Serum NO, MDA, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and H. pylori infection status were determined for each subject. Serum NO levels and OSI index were found to be increased (p = .001 and .013, respectively) and TAS levels were decreased (p < .001) in HEG patients compared with both controls regardless of H. pylori infection status. Serum MDA and TOS levels were not different between the study groups. Helicobacter pylori infection rates were similar in each group. The reduced antioxidant activities, as well as the increased OSI and NO levels in HEG patients indicate possible oxidative stress conditions in HEG patients. Moreover, serum NO levels may be used as an adjunctive marker to distinguish HEG patients from other causes of emesis during pregnancy. Impact statement What is already known on this subject? Current evidence suggests that oxidative stress is a significant factor responsible for a number of complications during pregnancy. What do the results of this study add? Hyperemesis gravidarum is an oxidative stress condition, as reflected by increased nitric oxide (NO) and decreased total antioxidant status activity, regardless of H. Pylori infection. What are the implications for clinical practice and/or further research? Full disclosure of the association between circulating NO and hyperemesis gravidarum would shed light on underlying biological mechanisms and could help clinical management of similar pregnancy-associated morbidity states.
由于妊娠剧吐（HEG）患者持续氧化应激的生化和分子机制尚未完全阐明，本研究旨在评估一氧化氮（NO）、丙二醛（MDA）和其他氧化应激标志物在该疾病病理生理学中的可能作用。此外，还研究了氧化应激标志物与幽门螺杆菌（H. pylori）感染之间的关系。将患有HEG并发症的孕妇（n = 33）与未患HEG的孕妇（n = 30）以及健康非孕妇（n = 31）进行比较。测定了每个受试者的血清NO、MDA、总氧化剂状态（TOS）、总抗氧化剂状态（TAS）、氧化应激指数（OSI）和H. pylori感染状态。结果发现，无论H. pylori感染状态如何，与两个对照组相比，HEG患者的血清NO水平和OSI指数均升高（分别为p = 0.001和0.013），而TAS水平降低（p < 0.001）。各研究组之间血清MDA和TOS水平无差异。每组中的幽门螺杆菌感染率相似。HEG患者抗氧化活性降低以及OSI和NO水平升高表明其可能存在氧化应激状况。此外，血清NO水平可作为辅助标志物，用于区分HEG患者与妊娠期间其他呕吐原因。影响声明关于该主题已知的信息有哪些？当前证据表明氧化应激是妊娠期间许多并发症的重要因素。本研究结果增加了什么？妊娠剧吐是一种氧化应激状况，表现为一氧化氮（NO）增加和总抗氧化剂状态活性降低，无论是否感染H. Pylori。对临床实践和/或进一步研究有何启示？全面揭示循环NO与妊娠剧吐之间的关联将有助于阐明潜在的生物学机制，并有助于对类似妊娠相关发病状态进行临床管理。
