Serum Uric Acid Level as a Predictive Biomarker of Gestational Hypertension Severity; A Prospective Observational Case-Control Study

Abstract

<jats:sec> <jats:title>Background:</jats:title> <jats:p>Pre-eclampsia poses a significant potential risk of hypertensive disorders during pregnancy, a leading cause of maternal deaths. Hyperuricemia is associated with adverse effects on endothelial function, normal cellular metabolism, and platelet aggregation and adhesion. This study was designed to compare serum urate levels in normotensive pregnant women to those with pregnancy-induced hypertension, and to evaluate its value as a potential predictive marker of hypertension severity during pregnancy.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p> A prospective, observational, case-control study conducted on 100 pregnant women in their third trimester. Pregnant women were classified into two groups (n=50) according to arterial blood pressure measurements: group I had normal blood pressure, and group II had a blood pressure of ≥ 140/90, which was further subdivided according to hypertension severity into IIa (pregnancy-induced hypertension, IIb (mild pre-eclampsia), and IIc (severe pre-eclampsia). Blood samples were obtained on admission. Serum urate, high sensitive C-reactive protein, and interleukin-1β levels, and lipid profile were compared across the groups.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> A significant increase in the mean values of serum urate, C-reactive protein, and interleukin-1β levels were detected in gestational hypertensives. Also, there was a positive correlation between serum urate levels and C-reactive protein and interleukin-1β, as well as between Serum urate levels and hypertension severity.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>Hyperuricemia and increased C-reactive protein and interleukin-1β serum levels correlate with the severity of pregnancy-induced hypertension, and these biomarkers may play a role in the pathogenesis of pre-eclampsia. Serum urate measurement is sensitive, reliable markers that correlate well with the severity of hypertension in pregnant females with pre-eclampsia.</jats:p> </jats:sec>

Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective

“…Likewise, this close relationship between UA and hypertension also exists in pregnant women. The level of sUA in pregnant women is higher than that in normal, nonpregnant women, and the incidence of hypertensive disorders of pregnancy is significantly increased in pregnant women with hyperuricemia (Sakr et al, 2020). The mechanisms of increased UA level during pregnancy may be related to the decrease of estrogen concentration, the increase of high purine food intake, and the increase of XO activity.…”

Metabolomics of Artichoke Bud Extract in Spontaneously Hypertensive Rats

“…Federica et al first reported the relationship between serum UA and hypertension in 1870 . Previous studies have shown that impaired excretion of renal uric acid and the final product of purine metabolism trigger hyperuricemia, whereas elevated levels enhance the development of hypertension in the general population. , Nevertheless, Feig et al discovered that reducing uric acid levels using allopurinol, an inhibitor of xanthine oxidase, lowered blood pressure . Antihypertensive drugs have been shown to affect uric acid levels, and, in turn, most hypouricemia drugs have been shown to have an effect on blood pressure. , Animal and cell experiments revealed that the up-regulation of the RAAS contributed to the role of uric acid in promoting hypertension and inflammatory status .…”

“…62 Previous studies have shown that impaired excretion of renal uric acid and the final product of purine metabolism trigger hyperuricemia, 63 whereas elevated levels enhance the development of hypertension in the general population. 62,64 Nevertheless, Feig et al discovered that reducing uric acid levels using allopurinol, an inhibitor of xanthine oxidase, lowered blood pressure. 65 Antihypertensive drugs have been shown to affect uric acid levels, and, in turn, most hypouricemia drugs have been shown to have an effect on blood pressure.…”

Association of CRP Levels in 3rd Trimester with Fetal Birth Weight in Normotensive and Preeclamptic Pregnant Females

“…In 2015, Üstün and colleagues reported higher levels of hsCRP in patients with mild to severe pre-eclampsia compared to normal pressure controls. They used a nephelometric test to measure CRP levels and found a positive correlation between CRP and mean arterial pressure 19 .…”