Cerebral Osmolytes and Plasma Osmolality in Pregnancy and Preeclampsia: A Proton Magnetic Resonance Spectroscopy Study
| Autor: | Lina Bergman, Maria Nelander, Anders Larsson, Johan Wikström, Inger Sundström-Poromaa, Jan Weis, Anna-Karin Wikström |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Taurine Proton Magnetic Resonance Spectroscopy Glutamic Acid 030204 cardiovascular system & hematology Creatine Preeclampsia Choline 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine Pre-Eclampsia Predictive Value of Tests Pregnancy Seizures Internal medicine Internal Medicine Medicine Humans business.industry Osmolar Concentration Sodium Glutamate receptor medicine.disease Pathophysiology Plasma osmolality Endocrinology Cross-Sectional Studies chemistry Osmolyte Case-Control Studies Cerebrovascular Circulation Female business 030217 neurology & neurosurgery Biomarkers Inositol |
| Zdroj: | American journal of hypertension. 31(7) |
| ISSN: | 1941-7225 |
| Popis: | BACKGROUND Cerebral complications contribute substantially to mortality in preeclampsia. Pregnancy calls for extensive maternal adaptations, some associated with increased propensity for seizures, but the pathophysiology behind the eclamptic seizures is not fully understood. Plasma osmolality and sodium levels are lowered in pregnancy. This could result in extrusion of cerebral organic osmolytes, including the excitatory neurotransmitter glutamate, but this remains to be determined. The hypothesis of this study was that cerebral levels of organic osmolytes are decreased during pregnancy, and that this decrease is even more pronounced in women with preeclampsia. METHODS We used proton magnetic resonance spectroscopy to compare levels of cerebral organic osmolytes, in women with preeclampsia (n = 30), normal pregnancy (n = 32), and nonpregnant controls (n = 16). Cerebral levels of organic osmolytes were further correlated to plasma osmolality and plasma levels of glutamate and sodium. RESULTS Compared to nonpregnant women, women with normal pregnancy and preeclampsia had lower levels of the cerebral osmolytes, myo-inositol, choline and creatine (P = 0.001 or less), and all these metabolites correlated with each other (P < 0.05). Women with normal pregnancies and preeclampsia had similar levels of osmolytes, except for glutamate, which was significantly lower in preeclampsia. Cerebral and plasma glutamate levels were negatively correlated with each other (P < 0.008), and myo-inositol, choline and creatine levels were all positively correlated with both plasma osmolality and sodium levels (P < 0.05). CONCLUSIONS Our results indicate that pregnancy is associated with extrusion of cerebral organic osmolytes. This includes the excitatory neurotransmitter glutamate, which may be involved in the pathophysiology of seizures in preeclampsia. |
| Databáze: | OpenAIRE |
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