ÖZLEM ÖZPAK AKKUŞ, FATMA GÜLHAN SAMUR, Melih AKKUŞ, Nuri DANIŞMAN

Sağlıklı ve Preeklamptik Gebelerin Serum Homosistein, Folik Asit ve B12 Vitamin Düzeylerinin Karşılaştırılması

Amaç: Preeklampsinin (PE) etiyolojisinde yer alan endotel hasar ile yükselmiş homosistein düzeyleri ve düşük serum folik asit, ve B12 vitamini düzeyleri arasında önemli bir ilişkinin varlığı düşünülmektedir. Yüksek homosistein düzeyi, preeklampside vasküler endoteli oksidatif strese daha duyarlı hale getirmektedir. Bu çalışma, sağlıklı ve preeklamptik gebelerin serum B12 vitamini, folik asit ve homosistein düzeylerinin karşılaştırılarak preeklampsi oluşumundaki olası rolünü saptamak amacıyla yapılmıştır. Bireyler ve Yöntem: Araştırma, Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesinde perinatoloji servisinde preeklampsi tanısı ile izlenen preeklamptik 30 gebe ve sağlıklı normotansif 30 gebe (kontrol grubu) üzerinde yürütülmüştür. Araştırma kapsamında preeklamptik gebelere ve sağlıklı gebelere tanıtım bilgileri, beslenme durumlarını ve alışkanlıklarını içeren bir anket formu uygulanmış ve biyokimyasal analizleri (serum folik asit, B12 vitamini ve homosistein) yapılmıştır. Bulgular: Preeklamptik gebelerin ortalama serum homosistein düzeyi (7.7±3.3umol/L) sağlıklı gebelerin homosistein düzeyinden (6.1±3.1 umol/L) yüksek bulunmuştur (p0.05). Gebelikte multivitamin desteği alan preeklamptik gebelerin serum homosistein düzeyi (6.70±2.90 μmol/L) kontrol grubuna (6.10±3.06μmol/L) göre yüksek bulunmuştur (p

Comparison of Homocysteine, Folic Acid and Vitamin B12 Levels in Preeclampsia and Healthy Pregnant Women

Aim: Endothelial dysfunction is the most popular hypothetic factor in the etiopathogenesis of preeclampsia. Therefore, it has been suggested that hyperhomocysteinemia during pregnancy may contribute to the occurrence of preeclampsia. This study is designed to determine the possible effects of serum vitamin B12, folic acid and homocysteine levels on preeclampsia in both preeclamptic and healthy women. Subjects and Methods: This research was performed in Zekai Tahir Burak Women Health Care, Education and Research Hospital perinatology service involving 30 pregnant women with preeclampsia and 30 healthy pregnant women as a control group. Within the research a questionnaire about participants nutrition status and habits was applied to the preeclamptic and healthy pregnant women by the researcher. Results: Serum folic acid, vitamin B12 and homocysteine levels of all participants were measured. Mean homocysteine levels of the preeclamptic women (7.7±3.3 umol/L) were found to be higher than the healthy pregnant women (6.1±3.1 umol/L) (p<0.05). Mean folic acid and vitamin B12 levels of the preeclamptic women (12.6±8,6 ng/mL, 180.0±87.6 q/mL) were found to be lower than the healthy pregnant women (13.9±8.4 ng/mL, 200.0±60.5 q/mL) (p>0.05). Mean serum homocysteine levels of the preeclamptic women who were taking multivitamin supplement were 6.70±2.90 μmol/L, whereas mean blood homocysteine levels of the control group were 6.10±3.06μmol/L (p<0.05). Serum homocysteine level differences between pregnant women multivitamin users and nonusers was found to be significant (p<0.05). No significant correlation was observed between the dietary folate and vitamin B12 intake and plasma folic acid and B12 levels (p>0.05).The plasma homocysteine levels were demonstrated to be higher in pregnant women with a higher dietary vitamin B12 intake (p<0.05). Conclusion: Serum homocysteine levels were found to be significantly higher in preeclampsia group compared to control group, suggesting that elevated serum levels of homocysteine might be associated with preeclampsia. The observation of no difference in vitamin B12 and folic acid levels between the groups suggesting that these are not the only factors playing role in the occurrence of hyperhomocysteinemia in preeclampsia and this requires further investigation.

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