Vol 82, No 3 (2011)

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The possible role of adrenomedullin in the etiology of gestational hypertension and preeclampsia

Adrianna Boć-Zalewska, Agnieszka Seremak-Mrozikiewicz, Magdalena Barlik, Grażyna Kurzawińska, Krzysztof Drews
Ginekol Pol 2011;82(3).


Summary Introduction: Nowadays the possible role of vasoactive peptide adrenomedullin (ADM) is considered in the etiology of preeclampsia (PE), where ADM is indicated to be a protective factor decreasing blood pressure. The aim of this study was to evaluate the role of –1984A>G ADM gene polymorphism and its connection with ADM plasma level in women with gestational hypertension (GH) and preeclampsia. Material and methods: 63 hypertensive (30 with GH and 33 with PE) and 94 healthy pregnant women were included into the study. The frequency of genotypes and alleles of –1984A>G ADM gene polymorphism was examined by PCR/RFLP method. ADM concentration was measured by ELISA method. Results: In GH subgroup higher frequency of heterozygous AG genotype (16.67% vs. 8.50%, O.R.=2.68, p=ns) and G allele (11.67 vs. 4.30%, O.R.=2.97, p=0.043) was observed. In PE subgroup overrepresentation of heterozygous AG genotype (15.15% vs. 8.5%) and slightly higher frequency of G allele (p=ns) were noted. In AA genotype subgroup of hypertensive women in comparison to the AG+GG genotype group higher proteinuria value (212.1 vs. 90.9 mg/dl, p<0.0001), lower systolic (171.1 vs. 177.3 mmHg), as well as lower diastolic blood pressure level (107.1 vs. 111.4 mmHg) were noted. The highest ADM plasma level was observed in the group of women with PE (1.817 vs. 1.692 ng/ml, p=ns). Moreover, higher ADM plasma concentration in patients with AA genotypes in comparison to the carriers of AG and GG genotypes (1.844 vs. 1.402 ng/ml, p=ns) was noted. Conclusions: Higher ADM plasma concentration in women with PE suggests possible correlation between ADM level and pathological changes in cardiovascular system during pregnancy. Overrepresentation of genotypes containing at least one mutated G allele of the -1984A>G ADM gene polymorphism in women with GH and PE suggests participation of this allele in pathogenesis of these conditions. Higher ADM concentration in carriers of homozygous AA genotype found in GH and PE groups indicates the possible important role of A allele in prevention of GH/PE appearance.

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