Division of Nephrology and Hypertension (S.S., S.P., M.J., A.K., V.D.G.), Mayo Clinic College of Medicine and Science, Rochester, MN.
Department of Physiology and Biomedical Engineering (S.S., M.J.), Mayo Clinic College of Medicine and Science, Rochester, MN.
Hypertension. 2024 Jul;81(7):1550-1560. doi: 10.1161/HYPERTENSIONAHA.123.22250. Epub 2024 May 1.
Senescence, a mechanism of cellular aging, which is characterized by irreversible proliferation arrest and a proinflammatory secretory phenotype, has been documented in women with preeclampsia. As cellular senescence can persist and progress, we postulated that it is associated with accelerated aging phenotype and accumulation of comorbidities in women with a history of preeclampsia.
We included a cohort of women with a history of preeclampsia (n=40) age- and parity-matched to a group of referent women with normotensive pregnancies (n=40). Women with prior major cardiovascular events, neurological, or autoimmune conditions were excluded. We collected urine and blood samples to study markers of aging, data on multimorbidity at the time of enrollment, and prospectively followed them for events over the course of 6 years, on average.
Women with a history of preeclampsia exhibited unfavorable aging profiles compared with referent women, including decreased urinary α-Klotho (=0.018); increased leptin (=0.016) and leptin/adiponectin ratio (=0.027), and increased extracellular vesicles positive for tissue factor (=0.025). Women with a history of preeclampsia likewise had a higher rate of comorbidities at the time of enrollment (=0.003) and had a 4× higher risk of developing major cardiovascular events compared with referent women (=0.003).
Our data suggest that a history of preeclampsia is associated with accelerated aging as indicated by senescence marker differences and the accumulation of multimorbidity later in life. Targeting cellular senescence may offer novel, mechanism-based approaches for the diagnosis and treatment of adverse health outcomes in women with a history of preeclampsia.
衰老,即细胞衰老的机制,其特征是不可逆的增殖停滞和促炎分泌表型,已在子痫前期女性中得到证实。由于细胞衰老可以持续和进展,我们假设它与加速衰老表型和子痫前期史女性合并症的积累有关。
我们纳入了一组有子痫前期史的女性(n=40),并与一组正常血压妊娠的女性(n=40)按年龄和产次匹配。排除有先前主要心血管事件、神经或自身免疫疾病的女性。我们收集尿液和血液样本以研究衰老标志物、纳入时合并症的数据,并前瞻性地随访她们平均 6 年的事件。
与对照女性相比,有子痫前期史的女性表现出不利的衰老特征,包括尿 α-Klotho 减少(=0.018);瘦素增加(=0.016)和瘦素/脂联素比值增加(=0.027),以及组织因子阳性的细胞外囊泡增加(=0.025)。有子痫前期史的女性在纳入时同样合并症的发生率更高(=0.003),与对照女性相比,发生主要心血管事件的风险增加了 4 倍(=0.003)。
我们的数据表明,子痫前期史与衰老标志物差异和晚年合并症的积累所指示的加速衰老有关。靶向细胞衰老可能为子痫前期史女性的不良健康结局提供新的、基于机制的治疗方法。