Karthiga Kuzhanthaivelu, Pal Gopal Krushna, Dasari Papa, Nanda Nivedita, Velkumary Subramanian, Chinnakali Palanivel
Department of Physiology, JIPMER, Puducherry, India.
Department of Obstetrics and Gynecology, JIPMER, Puducherry, India.
Clin Exp Hypertens. 2021 May 19;43(4):356-362. doi: 10.1080/10641963.2021.1883053. Epub 2021 Feb 11.
Decreased baroreflex sensitivity (BRS) and sympathovagal imbalance (SVI) have been reported as a cardiovascular (CV) risk in gestational hypertension (GH). Nitric oxide (NO) has been implicated in pathophysiology of GH. In the present study, we assessed the link of CV risks (decreased BRS and SVI) to the plasma levels of NO in women having risk of developing GH. A total of 96 pregnant women having risk factors for GH were recruited for the study. The blood pressure variability (BPV), heart rate variability (HRV), plasma NO, marker of insulin resistance (HOMA-IR), lipid risk factors, inflammatory markers (hsCRP, interleukin-6), and malondialdehyde (MDA), the marker of oxidative stress (OS) were measured at 16 and 36 week. Link of various parameters to NO was assessed by correlation and multiple regression analysis. Of HRV indices, parasympathetic components were decreased and sympathetic components were increased, BRS was decreased, NO was decreased, HOMA-IR, lipid risk factors, hsCRP, interleukin-6, and MDA were increased significantly at 36 week compared to 16 week of pregnancy. Most of the markers of cardiometabolic risk were correlated with NO. However, only the markers of CV risk (SVI and reduced BRS) were independently associated with decreased level of NO, but not the metabolic markers except interleukin-6. The independent contribution of BRS (β = 0.334, < .001) to NO was found to be most significant. It was concluded that decreased BRS, SVI, and increased interleukin-6 are associated with reduction in NO in GH, which may possibly be linked to the development of CV risks in GH.
压力反射敏感性（BRS）降低和交感迷走神经失衡（SVI）已被报道为妊娠期高血压（GH）的心血管（CV）风险因素。一氧化氮（NO）与GH的病理生理学有关。在本研究中，我们评估了有发生GH风险的女性中CV风险（BRS降低和SVI）与血浆NO水平之间的联系。共有96名有GH风险因素的孕妇被纳入本研究。在孕16周和36周时测量血压变异性（BPV）、心率变异性（HRV）、血浆NO、胰岛素抵抗标志物（HOMA-IR）、脂质风险因素、炎症标志物（hsCRP、白细胞介素-6）以及氧化应激（OS）标志物丙二醛（MDA）。通过相关性和多元回归分析评估各种参数与NO的联系。在HRV指标中，副交感神经成分降低，交感神经成分增加，BRS降低，NO降低，与孕16周相比，孕36周时HOMA-IR、脂质风险因素、hsCRP、白细胞介素-6和MDA显著增加。大多数心脏代谢风险标志物与NO相关。然而，只有CV风险标志物（SVI和降低的BRS）与NO水平降低独立相关，除白细胞介素-6外的代谢标志物则不然。发现BRS对NO的独立贡献（β = 0.334，P <.001）最为显著。得出的结论是，BRS降低、SVI降低以及白细胞介素-6增加与GH中NO的减少有关，这可能与GH中CV风险的发展有关。
