RESUMEN
Hepatitis E virus (HEV) infection is associated with high maternal and fetal mortalities. The aim of the study was to find cytokine gene polymorphisms in relation to HEV infection during pregnancy. A total of 262 pregnant and 208 non-pregnant women with hepatitis, 262 healthy pregnant and 208 non-pregnant women as controls. The study group were pregnant and non-pregnant women with HEV infection, not infected with HEV and controls. Genotyping was carried out by PCR-RFLP and ARMS-PCR methods. The frequencies of TNF-α -308 A allele & AA genotype, IFN-γ +874 T allele & TT genotypes were significantly higher in pregnant women with HEV infection compared to other groups. The frequency of TGF-ß1 codon 10 +869 T allele &TT genotype and codon 25 +915 G allele & GG genotype were significantly higher in pregnant women compared to non-pregnant women with HEV infection. The frequency of IL-6-174 GG genotype was significantly higher in pregnant women with HEV infection compared to not infected with HEV and controls. Cytokine gene polymorphisms shows association with preterm delivery (TNF-α -308 AA, IFN-γ +874 AA, TGF-ß1 codon 10 +869 TT & codon 25 GG genotypes), low birth weight (TNF-α -308 GG & IL-6 -174 CC genotypes), fetal loss (IL-6-174 CC genotype), and small for date (IL-6-174 CC & TGF-ß1 codon 10 +869 TC genotypes) of HEV infected pregnant women compared to not infected with HEV and controls. These findings suggest that cytokines gene polymorphisms were found to be associated with pregnant women with HEV infection and adverse pregnancy outcome.
Asunto(s)
Citocinas/genética , Hepatitis E/genética , Hepatitis E/inmunología , Polimorfismo de Nucleótido Simple , Complicaciones Infecciosas del Embarazo/genética , Complicaciones Infecciosas del Embarazo/inmunología , Resultado del Embarazo , Adolescente , Adulto , Codón , Femenino , Frecuencia de los Genes , Técnicas de Genotipaje , Humanos , Recién Nacido , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Embarazo , Adulto JovenRESUMEN
AIMS: The aim of this study was to evaluate tumour necrosis factor-alpha (TNF-α), interleukin (IL)-6, interferon gamma (IFN-γ) and transforming growth factor-beta1 (TGF-ß1) in hepatitis E infection during pregnancy and its relation with pregnancy outcome. METHODS: A total of 272 pregnant and 219 non-pregnant women with hepatitis and 262 age and gestational age matched healthy pregnant women and 208 age matched, healthy non-pregnant women were evaluated on the basis of history, clinical examination, liver function profile. Serological tests of hepatitis A, B, C and E and cytokines using commercially available (ELISA) kits. The patients with hepatitis E were further evaluated for viral load by Real Time PCR. All these were followed till delivery for pregnancy outcome. RESULTS: HEV viral load in acute viral hepatitis (AVH) and fulminant hepatic failure (FHF) of pregnant women were comparatively higher than non-pregnant women. Significantly higher levels of TNF-α, IL-6, IFN-γ and TGF-ß1 were present in HEV infected pregnant women compared to non-pregnant women and controls. TNF-α, IL-6 and IFN-γ had significant positive correlation with viral load, serum bilirubin and prothrombin time in pregnant women. Higher levels of all four cytokines were found in pregnant women with HEV infection having adverse pregnancy outcome compared to that of pregnant women with non-HEV infection and controls. CONCLUSION: In conclusion, severity of HEV infection and associated adverse pregnancy outcome might be mediated by cytokine in pregnancy.
Asunto(s)
Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/inmunología , Interferón gamma/sangre , Interleucina-6/sangre , Complicaciones Infecciosas del Embarazo/inmunología , Factor de Crecimiento Transformador beta1/sangre , Factor de Necrosis Tumoral alfa/sangre , Adulto , Bilirrubina/sangre , Femenino , Humanos , Fallo Hepático Agudo/virología , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Tiempo de Protrombina , Carga Viral , Adulto JovenRESUMEN
BACKGROUND & OBJECTIVES: The osteoporotic risk for women increases soon after menopause. Bone turnover markers are known to be associated with bone loss and fracture risk. This study was aimed to assess bone turnover using bone markers and their correlation with bone mineral density (BMD) in pre- and post-menopausal women. METHODS: A total of 255 healthy women (160 pre- and 95 post-menopausal) were enrolled. Serum bone alkaline phosphatase (sBAP) and serum N-terminal telopeptide of type I collagen (NTX) were measured to evaluate the bone formation and resorption, respectively. Bone mineral density was determined at lumbar spine (L2-L4) anteroposteriorly, femoral neck and Ward's triangle using Prodigy dual-energy X-ray absorptiometry (DXA) system. The comparison of years since menopause with respect to BMD and bone markers was also evaluated. RESULTS: NTX and sBAP showed significant negative correlation with BMD of femur neck and Ward's triangle in postmenopausal women. BMD of all three sides were significant variables for NTX and BMD of femur neck and Ward's triangle for sBAP in postmenopausal women. BMD lumbar spine was a significant variable for sBAP in premenopausal women. The mean values of NTX increased significantly with increase in the duration of years since menopause. The BMD of all three sides decreased significantly with increase in the duration of years since menopause. INTERPRETATION & CONCLUSIONS: Serum NTX and sBAP were inversely correlated to BMD of femur neck and Ward's triangle in post-menopausal women. Simultaneous measurements of NTX and BMD in the north Indian women, suggest that bone resorption in women with low BMD remains high after menopause.
Asunto(s)
Densidad Ósea , Huesos/fisiopatología , Osteoporosis Posmenopáusica/fisiopatología , Absorciometría de Fotón , Adulto , Anciano , Fosfatasa Alcalina/sangre , Colágeno Tipo I/sangre , Femenino , Fémur/patología , Humanos , India , Persona de Mediana Edad , Osteoporosis/sangre , Osteoporosis/fisiopatología , Osteoporosis Posmenopáusica/sangre , Péptidos/sangreRESUMEN
AIM: This prospective study aims to investigate the levels of bone turnover markers in pregnancy and correlate it with the assessment of preeclampsia. METHODS: A total of 140 women were followed up during their pregnancy. The women who developed preeclampsia (n=22), were compared with age-matched women (controls) who did not develop preeclampsia and had an uncomplicated pregnancy (n=22). Maternal serum levels of serum bone-specific alkaline phosphatase (sBAP), a marker of bone formation, and N-telopeptide of type 1 collagen (NTx), a marker of bone resorption, were estimated at recruitment (in the second trimester) and at delivery. sBAP and NTx levels were measured by enzyme immunoassay (EIA) and enzyme linked immunosorbent assay (ELISA), respectively. Serum and urinary calcium titers were compared by using a commercially-available calcium assay kit. RESULTS: Serum NTx levels increased significantly during pregnancy (P<0.02) and were significantly higher at delivery (P<0.01) in women with preeclampsia compared with controls. The levels of sBAP and serum calcium did not change significantly in both groups during pregnancy. There was no significant correlation between sBAP and NTx with maternal factors. A negative correlation was observed between sBAP and NTx levels in the preeclamptic group. CONCLUSIONS: Biochemical markers of bone turnover are greater in preeclampsia compared with normal pregnancy only when the disease is clinically evident (at delivery).
Asunto(s)
Fosfatasa Alcalina/sangre , Resorción Ósea/sangre , Colágeno Tipo I/sangre , Osteogénesis/fisiología , Péptidos/sangre , Preeclampsia/sangre , Adulto , Biomarcadores/sangre , Parto Obstétrico , Femenino , Humanos , India , Embarazo , Segundo Trimestre del Embarazo , Estudios ProspectivosRESUMEN
BACKGROUND & OBJECTIVE: Hepatitis E virus (HEV) is a major public health problem in the developing countries. HEV infection in pregnant women is more common and fatal in the third trimester. The mortality rate due to HEV-induced hepatitis is as high as 15-20 per cent. The present study was designed to determine the seroprevalence of subclinical HEV infection in pregnant primigravidae women. METHODS: A total of 300 asymptomatic healthy primigravidae (gestational age 16-24 wk) with no history of jaundice were included in the study. Prevalence of anti-HEV antibodies was determined by an enzyme linked immunosorbent assay (ELISA) kit. RESULTS: The overall prevalence of seropositive HEV IgG was 33.67 per cent among the pregnant women. The seropositivity of HEV IgG was significantly high in urban population (P<0.05), and related with the period of settlement (P<0.05) and source of water (P=0.05). Low socio-economic status of the pregnant women appeared to be the only risk factor (OR=1.96, CI=1.17-3.28) associated with HEV IgG antibody. INTERPRETATION & CONCLUSION: In the present study, exposure to HEV during pregnancy was higher in urban (slum areas) than rural population. Socio-economic status was a risk factor for anti-HEV IgG in pregnant women. Early preventive measures if taken, may decrease the maternal and perinatal mortality and morbidity of HEV infection.
Asunto(s)
Hepatitis E/complicaciones , Hepatitis E/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Adolescente , Adulto , Femenino , Anticuerpos Antihepatitis/sangre , Hepatitis E/inmunología , Humanos , Inmunoglobulina G/sangre , India/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , Factores de Riesgo , Estudios Seroepidemiológicos , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: To study the effect of calcium supplementation during pregnancy on blood pressure and maternal and neonatal outcomes. METHOD: A total of 524 healthy primigravidas with a blood pressure less than 140/90 mm Hg were randomly assigned between the 12th and 25th weeks to receive 2 g of elemental calcium or placebo and were followed-up until delivery. RESULTS: The incidence of pre-eclampsia was significantly less in the calcium than in the placebo group (4.0% vs 12.0%; odds ratio [OR], 0.31; 95% confidence interval [CI], 0.15-0.63); the mean systolic and diastolic blood pressures at study completion were different in the calcium and placebo group (P=0.007 and P=0.02). The risk for preterm delivery was less in the calcium (7.0%) than in the placebo (12.7%) group (OR, 0.51; 95% CI, 0.28-0.93). The mean baseline calcium intake was 313.83+/-203.25 mg/day (range, 85.71-910.71 mg/day), which is lower than the recommended dietary intake of 1000 mg, and the 24-hour urinary calcium excretion was 130.82+/-67.44 mg/dL (range, 40.5-387 mg/dL). CONCLUSION: Calcium supplementation appears to reduce the occurrence of pre-eclampsia and preterm delivery in primigravidas who have a daily dietary calcium intake less than the recommended dietary allowances.