Zirkadiane Rhythmik des Blutdrucks und der VCAM-1-Konzentration im Serum und Urin bei hypertensiven Schwangeren - Correlation between Circadian Blood Pressure Rhythm, VCAM-1 Serum Level, and Urinary VCAM-1 Excretion in Preeclampsia -

Abstract

Objective: Elevated levels of the vascular cell adhesion molecule-1 (VCAM-1) in women with preeclampsia may reflect endothelial damage and leukocyte activation. Urinary VCAM-1 excretion in normal pregnancies and those complicated by hypertension has not been studied. We studied the circadian pattern of VCAM-1 levels in the serum and urinary excretion of VCAM-1 in normal pregnancies and those complicated by hypertension and analyzed their relation with maternal blood pressure. Methods: Serum and urine samples were obtained at 1-hour and 2-hour intervals, respectively, over a 24-hour period from 10 normotensive and 10 hypertensive pregnant women. VCAM-1 levels were measured by ELISA. Blood pressure was recorded continuously over the 24-hour period. Results: Serum VCAM-1 levels and urinary VCAM-1 excretion were significantly higher in the hypertensive patients than in the controls (851 vs. 659 ng/ml and 62.0 vs. 29.4 pg/min, respectively ; P < 0.01). Serum VCAM-1 levels did not show a circadian pattern. In contrast, urinary excretion of VCAM-1 showed a circadian pattern in both groups with a maximum in the daytime hours. There was no correlation with circadian blood pressure variations. Conclusion: Urinary excretion of VCAM-1 shows a circadian pattern in both normotensive and hypertensive pregnancies. Urinary excretion is independent of the serum levels of VCAM-1, which remain stable, and of blood pressure. This suggests intrinsic renal endothelial dysfunction in pregnancies complicated by preeclampsia.