From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (M.B.B., S.Y.P., J.-K.Y., M.H., Y.O., S.S.J., A.S.S., S.A.B., Q.F.).
Internal Medicine, University of Texas Southwestern Medical Center, Dallas (M.B.B., S.Y.P., J.-K.Y., M.H., Y.O., S.S.J., A.S.S., S.A.B., D.B.N., Q.F.).
Hypertension. 2019 Feb;73(2):432-439. doi: 10.1161/HYPERTENSIONAHA.118.12137.
Corin (an atrial natriuretic peptide-converting enzyme) represents a potential biomarker for gestational hypertensive disorders; yet, its role in blood pressure (BP) regulation throughout pregnancy remains unclear. We investigated the time course of change in blood corin content in relation to BP and sympathetic nerve activity throughout pregnancy. Forty-four women (29±0.9 years) participated. Following-term, 23 had low-risk (no personal history of gestational hypertensive disorders) normal pregnancies, 13 had high-risk (personal history of gestational hypertensive disorders) normal pregnancies, and 8 developed gestational hypertension. BP, heart rate, muscle sympathetic nerve activity, and serum corin were measured before pregnancy, during early (4-8 weeks) and late pregnancy (32-36 weeks), and postpartum (6-10 weeks). Overall, compared with prepregnancy, corin remained unchanged during early pregnancy, increased markedly during late pregnancy ( P<0.001), and returned to prepregnancy levels postpartum. In women who developed gestational hypertension, the change in corin from early to late pregnancy was greater than those with low-risk normal pregnancies (Δ971±134 versus Δ486±79 pg/mL; P<0.05). Throughout pregnancy, BP and muscle sympathetic nerve activity were augmented in women with gestational hypertension (all P<0.05). Finally, changes in corin from early to late pregnancy were related to all indices of BP ( R=0.454-0.551; all P<0.01) in late pregnancy, whereas burst frequency, burst incidence, and total muscle sympathetic nerve activity ( R=0.576-0.614; all P<0.001) in early pregnancy were related to changes in corin from early to late pregnancy. Corin plays a unique role in BP regulation throughout normotensive and, especially, hypertensive pregnancy and may represent a promising biomarker for determining women at high risk of adverse pregnancy outcome.
心钠肽前体转换酶(Corin)是妊娠期高血压疾病的潜在生物标志物;然而,其在整个孕期血压(BP)调节中的作用尚不清楚。我们研究了整个孕期中血液 Corin 含量与 BP 和交感神经活性变化的时间进程。共有 44 名女性(29±0.9 岁)参与了研究。其中,23 名经产妇为低危(无妊娠期高血压疾病个人史)正常妊娠,13 名经产妇为高危(有妊娠期高血压疾病个人史)正常妊娠,8 名产妇发展为妊娠期高血压。在妊娠前、早孕期(4-8 周)、晚孕期(32-36 周)和产后(6-10 周)测量了 BP、心率、肌肉交感神经活性和血清 Corin。与妊娠前相比,整体而言,Corin 在早孕期无变化,在晚孕期明显增加(P<0.001),并在产后恢复到妊娠前水平。在发展为妊娠期高血压的女性中,Corin 从早孕期到晚孕期的变化大于低危正常妊娠的女性(Δ971±134 与 Δ486±79 pg/mL;P<0.05)。整个孕期,妊娠期高血压的女性 BP 和肌肉交感神经活性均增加(均 P<0.05)。最后,晚孕期时,Corin 从早孕期到晚孕期的变化与 BP 的所有指标相关(R=0.454-0.551;均 P<0.01),而早孕期时,Corin 从早孕期到晚孕期的变化与爆发频率、爆发发生率和总肌肉交感神经活性相关(R=0.576-0.614;均 P<0.001)。Corin 在正常妊娠和高血压妊娠期间的 BP 调节中发挥独特作用,可能是确定具有不良妊娠结局高危风险的女性的有前途的生物标志物。