Los niveles séricos de adenosin deaminasa y ácido úrico se correlacionan en pacientes gestantes con trastornos hipertensivos / Serum levels correlations of the enzyme adenosine deaminase (ADA) and uric acid in pregnant with hypertensive disorders

Objetivo: Evaluar los niveles séricos de la enzima adenosin-deaminasa (ADA) en pacientes gestantes normales y en pacientes con trastornos hipertensivos del embarazo, para determinar su relación con la gravedad del trastorno hipertensivo y con los niveles séricos de marcadores bioquímicos. Método: Se evaluaron pacientes con preeclampsia leve, preeclampsia grave, hipertensión gestacional y embarazadas sanas (n=10 por cada grupo). Se determinaron los niveles de ADA, ácido úrico, creatinina, amonio y enzimas hepáticas. Resultados: Se detectó una elevación en los niveles séricos de ADA en pacientes con preeclampsia y con hipertensión gestacional, en comparación con aquellas que cursaron con un embarazo normal. Los niveles ADA se correlacionaron positivamente con los niveles de ácido úrico y creatinina, más no con la severidad clínica. A su vez los niveles de ácido úrico se asociaron con la creatinina sérica y con la severidad clínica de los trastornos hipertensivos. Se encontró un incremento en los niveles de amonio en los pacientes con preeclampsia, el cual no se correlacionó con los otros marcadores bioquímicos, mientras que los niveles de TGO, TGP y LDH se encontraron significativamente elevados en la preeclampsia grave. Conclusión: Este estudio permite relacionar la actividad de ADA con los trastornos hipertensivos del embarazo, los niveles elevados de amonio con la preeclampsia y los niveles de ácido úrico, TGO, TGP y LDH con la severidad de los trastornos hipertensivos.

Objective: To evaluate serum levels of the enzyme adenosine deaminase (ADA) in normal pregnant and patients with hypertensive disorders induced by pregnancy, in order to determine their relationship with the severity of the hypertensive disorder and with serum biochemical markers. Method: We evaluated patients with mild preeclampsia, severe preeclampsia, gestational hypertension and healthy pregnancy (n=10 per group). We determined the serum levels of ADA, uric acid, creatinine, ammonia and liver enzymes. Results: In patients with preeclampsia and gestational hypertension we detected a rise in serum ADA as compared with those who had undergone a normal pregnancy. ADA levels were positively correlated with uric acid and creatinine serum levels, but not with clinical severity. Uric acid levels were associated with serum creatinine and the clinical severity of hypertensive disorders. We also found an increase in ammonia levels in patients with preeclampsia, which did not correlate with other biochemical markers, while the levels of SGOT, SGPT, and LDH were significantly elevated in severe preeclampsia. Conclusion: This study establishes a link between the activity of ADA with hypertensive disorders of pregnancy, high levels of ammonium with preeclampsia and uric acid, SGOT, SGPT and LDH levels with the severity of hypertensive disorders.

Biological and analytical variation of serum lipid profile

Dyslipidaemia is a major risk factor for coronary heart disease which can be assessed by measuring serum lipid profile. Biological variation has an important effect on the interpretation of all laboratory investigations, including lipid profile. To define the biological and analytical components of variation for the different parameters of serum lipid profile. The present study was conducted in Mosul City in northern Iraq, from 1[st] February to 30[th] April 2004. Fasting venous blood was collected from each of 10 apparently healthy volunteers [6 men and 4 women, aged 22-40 years], at 8-10 am following an overnight fast, at intervals of one week for 10 weeks. Sera were separated and stored frozen, in duplicate. Measurement and calculation of the different components of serum lipid profile were made including: triglycerides [TG], total cholesterol, HDL-C, LDL-C and ratios of total cholesterol: HDL-C, LDL-C: HDL-C and TG: HDL-C. The intra-individual [CVI] and inter-individual [CV[G]] variation were 21% and 37% for TG, 7.5% and 16.7% for total cholesterol, 11.2% and 24.5% for HDL-C, 13.7% and 28.3% for LDL-C, 13.1% and 25.4% for total cholesterol: HDL-C, 25.9% and 34.7% for LDL-C: HDL-C, and 27.2% and 40.7% for TG: HDL-C respectively. The indices of individuality, as reflected by CVI/CVG, for these parameters were all <1.0 [0.57 for TG, 0.45 for total cholesterol, 0.46 for HDL-C, 0.48 for LDL-C, 0.52 for total cholesterol: HDL-C, 0.95 for LDL-C: HDL-C and 0.85 for TG: HDL-C]. The analytical goals for imprecision, as reflected by analytical variation [CVA], was 6.3% for TG, 4.0% for total cholesterol, 5.2% for HDL-C, 7.8% for LDL-C, 5.8% for total cholesterol: HDL-C, 5.7% for LDL-C: HDL-C and 5.9% for TG: HDL-C. The critical difference calculated as 2.77 [CVA[2]+ CVI[2]][1/2] was 60.7% for TG, 23.5% for total cholesterol, 34.2% for HDL-C, 43.6% for LDL-C, 39.7% for total cholesterol: HDL-C, 73.3% for LDL-C: HDL-C and 97.5% for TG: HDL-C. The biological and analytical components of variation showed marked individuality. This together with the index of individuality supports the limited usefulness of using the conventional population-based reference range for interpretive criteria. The critical differences also confirm that single determination of lipid profile may have limited value in screening purpose