Association of serum hydrogen sulphide with hypertension and proteinuria in pre-eclampsia

Abstract

Background: Preeclampsia is a hypertensive disorder of pregnancy affecting multiple systems and characterized chiefly by hypertension and proteinuria in a previously normotensive and non proteinuric women. The main underlying cause for its pathophysiology is an imbalance between the physiological vasoconstrictor and vasodilator molecules in circulation leading to maternal endothelial dysfunction. Hydrogen sulphide (H2S) is a physiological vasodilatory gasotransmitter which plays an important role in the development of hypertension and proteinuria in preeclampsia.
 Aims and Objectives: The aim of this study was to determine the serum level of hydrogen sulphide and spot urinary protein levels in preeclampsia cases and compare it with age matched controls which were normal pregnant women and to find any correlation, if exists, between these two parameters.
 Materials and Methods: Serum level of H2S and spot urinary protein level were measured in one hundred pregnant women with preeclampsia and the values were compared with age matched controls.
 Results: The mean serum H2S level was 32.31 ± 12.62μmol/L in patients which was significantly lower (p<0.001) when compared to controls where mean was 114.50 ±20.35μmol/L. The mean spot urinary protein level was found to be 11.83 ± 5.06 mg/dl in preeclampsia cases which was significantly higher (p<0.001) than in controls where it was 7.18 ± 2.38 mg/dl. A negative correlation was found between the serum level of H2S and both the systolic BP (r=-0.725, p<0.001) and diastolic BP (r= - 0.639, p<0.001) in preeclampsia patients.A negative correlation was also observed between the serum levels of H2S and spot urinary protein in preeclampsia (r=-0.541, p<0.001).
 Conclusion: The present study has elucidated that the serum levels of hydrogen sulphide decreases and the spot urinary protein levels increases in preeclampsia when compared to normal pregnant women and hydrogen sulphide shows a negative correlation with both systolic and diastolic BP in preeclampsia. This study also demonstrates that,there exists a negative correlation between the serum H2S level and spot urinary protein level in preeclampsia patients.