The levels of TNFα, IL-1, IL-1β and calciferol and their relationship as markers of endothelial dysfunction in pregnant women with preeclampsia

Abstract

The objective: to determine blood levels of endothelial dysfunction markers (tumor necrosis factor α (TNF-α), interleukin (IL) 1β and IL-6) and vitamin D, and to assess their relationship in pregnant women with preeclampsia and in healthy pregnant women. Materials and methods. According to the “case-control” method, 61 women with preeclampsia (main group) and 35 healthy pregnant women (control group) were examined in the III trimester of gestation. Inclusion criteria: absence of diseases that can affect the metabolism of vitamin D (severe diseases of the liver, skin, kidneys and intestines). To exclude the influence of the season factor, the study was carried out in autumn. The levels of TNF-α, IL-6 and IL-1β, and vitamin D were determined by ELISA method in the blood of women. Results. By age (mean age in the main group was 28.60±4.77 years, in the control group –- 29.2±4.97) and the anthropometric data (the average value of body mass index in the main group was 22.67±1.11 kg/m2, control group – 22.44±1.97 kg/m2) the groups were similar. The gestational term for the delivery in the groups differed significantly: 35.86±1.21 weeks in the main group versus 39.2±1.7 weeks in the control group (p<0.01). A significant difference in the level of the markers between the patients of both groups was determined. The level of vitamin D in pregnant women with preeclampsia was 23.45±7.56 ng/ml, in healthy pregnant women – 44.08±7.16 ng/ml (p<0.01), TNF-α – 9.37±1.6 and 4.64±1.66 pg/ml (p<0.01), respectively, IL-6 – 7.98±2.88 and 4.52±1.49 pg/ml (p<0.01). In the main group, a negative insignificant correlation was established between the levels of vitamin D and TNF-α (rs=–0.18; p>0.05), in healthy women the correlation was significant (rs=0.378; p<0.05). There was a statistically significant correlation between the levels of vitamin D, IL-6 (rs=-0.797; p<0.01) and IL-1β (rs=-0.933; p<0.01) in women with preeclampsia. Conclusions. Vitamin D deficiency was found in the pregnant women with preeclampsia, which may be one of the conditions for the formation and implementation of an immunological imbalance in the form of activation of pro-inflammatory cytokines and generalized endothelial dysfunction.