Potential role of serum homocysteine and uric acid level as a predictive marker for pre-eclampsia

Saroj Kunwar; Rajesh Kumar Thakur; Rupa Nepal; Lakshan Paudel; Bimal Chaulaigai; Govinda Akela Paudel

doi:10.18203/issn.2454-2156.IntJSciRep20191858

Authors

Saroj Kunwar Department of Biochemistry, Modern Technical College, Sanepa-2, Lalitpur,
Rajesh Kumar Thakur Department of Biochemistry, Modern Technical College, Sanepa-2, Lalitpur,
Rupa Nepal Department of Microbiology, Modern Technical College, Sanepa-2, Lalitpur,
Lakshan Paudel Department of Biochemistry, Modern Technical College, Sanepa-2, Lalitpur,
Bimal Chaulaigai Department of Biochemistry, Modern Technical College, Sanepa-2, Lalitpur,
Govinda Akela Paudel Department of Physiology, Modern Technical College, Sanepa-2, Lalitpur,

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20191858

Keywords:

Pre-eclampsia, Hypertension, Uric acid, Homocysteine

Abstract

Background: Hypertension is one of the common disorders during pregnancy and can cause severe health complications for both mother and developing fetus. Pre-eclampsia (PE) is a form of hypertensive disorder complicating pregnancy. This study was aimed to estimate serum uric acid and homocysteine level as a potential biomarker for prediction of preeclampsia.

Methods: 85 pre-eclamptic pregnant women and 50 normotensive pregnant women were recruited from department of Obstetrics and Gynecology, Star Hospital after obtaining the informed written consent. Blood samples were collected and analyzed for serum homocysteine and serum uric acid level.

Results: Serum uric acid and homocysteine levels were found to be significantly higher in pre-eclamptic cases than in controls (6.5±0.7 mg/dl and 13.5±5.4 µmol/l in cases versus 4.3±0.8 mg/dl and 10.1±4.6 µmol/l in healthy controls). Maximum sensitivity and specificity of serum uric acid was obtained at a cut-off of 5.5 mg/dl (sensitivity- 91% and Specificity- 88%) and serum homocysteine at 10.7 µmol/l (sensitivity-67% and specificity-64%) respectively.

Conclusions: At optimum cut off value serum uric acid showed highest sensitivity and specificity for diagnosis of pre-eclampsia. Thus, serum uric acid level is better predictive marker compared to serum homocysteine level for pre-eclampsia.

Metrics

Metrics Loading ...

References

Hoque MM, Bulbul T, Mahal M, Islam N, Ferdausi M. Serum homocysteine in pre-eclampsia and eclampsia. Bangladesh Med Res Council Bull. 2008;34(1):16–20.

Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Look PF. WHO analysis of causes of maternal death: a systematic review. The Lancet. 2006;367(9516):1066–74.

Duley L. The Global Impact of Pre-eclampsia and Eclampsia. Seminars in Perinatol. 2009;33(3):130–7.

Basar G, Sangeeta N, Shaini L, Devi S, Chhuangi V, Mandal KK, et al. Serum Uric Acid and Homocysteine as Predictors of Pre-eclampsia. J Diabetes Metab. 2013;4(4).

Hietala R, Turpeinen U, Laatikainen T. Serum homocysteine at 16 weeks and subsequent preeclampsia. Obstet Gynecol. 2001;97(4):527–9.

Patel AP, Chakrabarti C, Singh A, Patel JD, Mewada HA, Sharma SL. Effect of Homocysteine ,Vitamin B12 , Folic acid during pregnancy. NHL J Med Sci. 2012;1(1):27–31.

Haltmayer M, Mueller T, Gegenhuber A, Poelz W. Comparison of the automated AxSYM and ADVIA centaur immunoassays for homocysteine determination. Clin Lab. 2004;50(3-4):175-80.

Zhao Y, Yang X, Lu W, Liao H, Liao F. Uricase based methods for determination of uric acid in serum. Microchimica Acta. 2009;164(1):1-6.

Khurshid R, Shamsi A, Fayyaz I, Zia M. Maternal Serum Uric Acid Level during Pregnancy: A Biomarker for Preeclampsia. P J M H S. 2016;10(2):413-6.

Amoakoh-Coleman M, Ogum-Alangea D, Modey-Amoah E, Ntumy MY, Adanu RM, Oppong SA. Blood pressure patterns and body mass index status in pregnancy: An assessment among women reporting for antenatal care at the Korle-Bu Teaching hospital, Ghana. PLoS One. 2017;12(12).

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. The Lancet. 2005;365(9461):785–99.

Klonoff-Cohen HS, Savitz DA, Cefalo RC, McCann MF. An epidemiologic study of contraception and preeclampsia. J Am Med Assoc. 1989;262: 3143–7.

Clausen T, Malene S, Solvoll K, Dreveon A, Vollset SE, Henriksen T. High intake of energy, sucrose, and polyunsaturated fatty acids is associated with increased risk of preeclampsia. Am J Obstet Gynecol. 2001;185(2):451-8.

Abrams BF, Laros RK. Prepregnancy weight, weight gain, and birth weight. Am J Obstet Gynecol. 1986;154(3):503–9.

Saftlas A, Wang W, Risch H, Woolson R, Hsu C, Bracken M. Prepregnancy body mass index and gestational weight gain as risk factors for preeclampsia and transient hypertension. Ann Epidemiol. 2000;10(7):475.

Al-Zubaidi Z. The Role of Uric Acid in Predicting Preeclampsia Women. J Chem Pharm Res. 2016;8(4):1175-9.

Wu Y, Xiong X, Fraser W, Luo Z. Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertension. 2012;25(6):711–7.

Andrew L, Patel N. Uric Acid Levels in Pregnancy Induced Hypertension (PIH) in Relation to Maternal and Perinatal Outcomes. Int J Clin Biochem Res. 2016;3(2):150.

Rajkovic A, Catalano PM, Malinow MR. Elevated homocyst(e)ine levels with preeclampsia. Obstet Gynecol. 1997;90(2):168–71.

Laskowska M, Laskowska K, Oleszczuk J. Interleukin-18 concentrations in pregnancies complicated by preeclampsia with and without IUGR: A comparison with normotensive pregnant women with isolated IUGR and healthy pregnant women. Pregnancy Hypertens. 2011;1(3):206–12.

Yelikar KA, Deshpande SS, Kulkarni ML. Association of maternal serum homocysteine level with severity of preeclampsia: a case control study. Int J Rep Contracep Obstet Gynecol. 2016;5(8):2713-7.

Noto R, Neri S, Noto Z, Cilio D, Abate G, Noto P, et al. Hyperhomocysteinemia in preeclampsia is associated to higher risk pressure profiles. Eur Rev Med Pharmacol Sci. 2003;7(3):81-7.

Hietala R, Turpeinen U, Laatikainen T. Serum homocysteine at 16 weeks and subsequent preeclampsia. Obstet Gynecol. 2001;97(4):527–9.

Ingec M, Borekci B, Kadanali S. Elevated plasma homocysteine concentrations in severe preeclampsia and eclampsia. Tohoku J Exp Med. 2005;206(3):225–31.