자간전증 환자에서 증가된 산화적 스트레스가 신생아의체중에 미치는 영향
Increased Oxidative Stress Affects the Neonatal Birth Weightin Preeclamptic Patients
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본 논문은 자간전증 환자에 있어서 모체내 호모시스테인, TBARS 및 GPX activity의 변화를 알아보고 이들 인자가 신생아의 체중에 미치는 영향을 알아보고자 하였다. 2000년 1월부터 2002년 12월까지 이대목동병원 산부인과에서 분만한 74명의 정상군과 47명의 자간전증 환자를 대상으로 하여 모체 혈액내 호모시스테인, TBARS, GPX activity 및 GPX activity/TBARS (antioxidant capacity)를 HPLC방법으로 측정하였고 GPX 유전자형은 PCR을 이용하였다. 통계는 Chi-square test, student t-test와 multiple logistic regression analysis를 사용하였다. 그 결과 호모시스테인과 TBARS는 정상 임신부에 비해 자간전증 환자에서 유의하게 높았으며 (p<0.05) antioxidant capacity는 자간전증 환자에서 정상 임신부에 비해 유의하게 낮았다 (p<0.05). 호모시스테인은 임신주수를 감소시켰고 신생아의 체중을 유의하게 감소시켰다.
Abstract
Objective : To assess the maternal circulating levels of homocysteine, the thiobarbituric acid reactive substances (TBARS) and the glutathione peroxidase (GPX) activities, and to determine whether or not these markers have any effect on the neonatal birth weight in preeclamptic patients. Methods : A case control study of 74 normal pregnant women and 47 preeclamptic patients who were hospitalized for delivery and had singleton live births between 2000 and 2002 was conducted. The birth weight, gestational age, and maternal circulating level of homocysteine, the TBARS, the GPX activities, and the antioxidant capacity (GPX/TBARS) were measured. GPX genotyping was done with the maternal DNA samples. The results were analyzed with a Chi-square test, student T-test, and logistic regression analyses. Results : The homocysteine and TBARS levels were significantly higher in the preeclamptic patients than in the pregnant controls (p=0.0098 for homocysteine, p<0.0001 for TBARS). The antioxidant capacity (GPX/TBARS) was significantly lower in the preeclamptic patients than in the pregnant controls (p<0.0001). There were no statistically significant differences in the homocysteine level, the TBARS levels, the GPX activity, the gestational age, and birth weight between the wild type of GPX polymorphism and the variant type of GPX polymorphism (p>0.05). After controlling for the covariates, homocysteine reduced the gestational age (p=0.0035) and reduced the birth weight by 27 g (p=0.0259). Conclusion : The levels of the oxidative stress markers (homocysteine and TBARS) are higher and the antioxidant capacity (GPX/TBARS) is lower in preeclampsia patients. Homocysteine significantly reduces the fetal growth rate.
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