ABSTRACT

Purpose: Decreased baroreflex sensitivity (BRS) and sympathovagal imbalance (SVI) have been reported as a cardiovascular (CV) risk in gestational hypertension (GH). Nitric oxide (NO) has been implicated in pathophysiology of GH. In the present study, we assessed the link of CV risks (decreased BRS and SVI) to the plasma levels of NO in women having risk of developing GH. Materials and Methods: A total of 96 pregnant women having risk factors for GH were recruited for the study. The blood pressure variability (BPV), heart rate variability (HRV), plasma NO, marker of insulin resistance (HOMA-IR), lipid risk factors, inflammatory markers (hsCRP, interleukin-6), and malondialdehyde (MDA), the marker of oxidative stress (OS) were measured at 16^th and 36^th week. Link of various parameters to NO was assessed by correlation and multiple regression analysis. Results: Of HRV indices, parasympathetic components were decreased and sympathetic components were increased, BRS was decreased, NO was decreased, HOMA-IR, lipid risk factors, hsCRP, interleukin-6, and MDA were increased significantly at 36^th week compared to 16^th week of pregnancy. Most of the markers of cardiometabolic risk were correlated with NO. However, only the markers of CV risk (SVI and reduced BRS) were independently associated with decreased level of NO, but not the metabolic markers except interleukin-6. The independent contribution of BRS (β = 0.334, P < .001) to NO was found to be most significant. Conclusion: It was concluded that decreased BRS, SVI, and increased interleukin-6 are associated with reduction in NO in GH, which may possibly be linked to the development of CV risks in GH.

 抽象的

目的：据报道，压力感受反射敏感性降低 (BRS) 和交感迷走神经失衡 (SVI) 是妊娠期高血压 (GH) 的心血管 (CV) 风险。一氧化氮 (NO) 与 GH 的病理生理学有关。在本研究中，我们评估了有 GH 风险的女性的 CV 风险（BRS 和 SVI 降低）与血浆 NO 水平的联系。材料和方法：本研究总共招募了 96 名具有 GH 危险因素的孕妇。血压变异性 (BPV)、心率变异性 (HRV)、血浆 NO、胰岛素抵抗标志物 (HOMA-IR)、血脂危险因素、炎症标志物 (hsCRP、白介素-6) 和丙二醛 (MDA)、胰岛素抵抗标志物在^第16 周和^第36 周测量氧化应激 (OS) 的情况。通过相关性和多元回归分析评估各种参数与 NO 的联系。结果： HRV指标中，^第36周与第16周相比，副交感成分减少，交感成分增加，BRS减少，NO减少，HOMA-IR、血脂危险因素、hsCRP、白细胞介素6、MDA显着升高。怀孕^第几周。大多数心脏代谢风险标志物与 NO 相关。然而，只有心血管风险标志物（SVI 和 BRS 降低）与 NO 水平降低独立相关，而除白细胞介素 6 之外的代谢标志物则不然。 BRS (β = 0.334, P < .001) 对 NO 的独立贡献最为显着。 结论：得出的结论是，BRS、SVI 的降低和白细胞介素 6 的增加与 GH 中 NO 的减少有关，这可能与 GH 中 CV 风险的发生有关。