ABSTRACT

Endothelial dysfunction, which is associated with decreased nitric oxide and hyperhomocysteinemia, is an essential component of preeclampsia Aim of our study was to investigate nitric oxide levels and homocysteine levels in preeclamptic women and to study the relationship between homocysteine and NO.

Thirty preeclamptic and thirty healthy pregnant women above 30 gestational weeks were included to study. Venous blood samples were collected from all women before administration of any drug. Homocysteine and two stable oxidation products of nitric oxide, nitrate and nitrite were analyzed in healthy pregnant women, mild preeclamptic, severe preeclamptic and eclamptic women.

Demographical and obstetrical characteristics of patients were similar, except blood pressure measurements. Mean of homocysteine values were significantly higher in preeclamptic women (9.0±3.4 μmol/l) than healthy controls (5.3±1.3 μmol/l). Homocysteine levels were found to be increased as the severity of preeclampsia increased; with highest level in eclamptic patients (14.0±1.8 μmol/l, p<0.001). Cut-off values with good sensitivity and specificity was reproduced by ROC analysis. There was no significant difference in serum nitrite and nitrate levels. No association between hyperhomocysteinemia and nitric oxide was found.

Preeclampsia and severity of this pregnancy associated catastrophic disease is well-correlated with level of serum homocysteine. However, nitric oxide levels are not altered. Pathophsiology of hyperhomocysteinemia in preeclampsia probably does not involve impinging upon nitric oxide.

Keywords: preeclampsia, eclampsia, nitric oxide, hyperhomocysteinemia