Role of ghrelin in normotensive and hypertensive pregnant women

ABSTRACT

Ghrelin, an endogenous ligand for the growth hormone secretagogues, was originally isolated from rat stomach. Ghrelin exhibits a wide variety of actions including vasodilatation, increasing appetite, interaction with hypothalamic nuclei stimulating feeding and determining body weight gain, blocking leptininduced feeding reduction implying that there is a competitive interaction between ghrelin and leptin and increasing gastrointestinal motility. To clarify the haemodynamic and metabolic role of ghrelin in normotensive pregnant female, pregnancy induced hypertension, spontaneously hypertensive pregnant femaleand preclampsia. 120 pregnant womenwere divided into 4 groups [normal, pregnancy-associated hypertension, pregnancy-induced hypertension and preclampsia], each group included 30 pregnant women. Pregnant women, at 20-26 weeks, 26-32 weeks and after 32 weeks, were subjected to thorough history taking, clinical examination and laboratory investigations as blood picture, urine analysis, liver function tests and measurement of serum ghrelin, eptin, nitric oxide, lipid profile, insulin and glucose. Glomerular filtration rate [GFR], body mass index [BMI] and pregnancy outcome were also determined. Arterial blood pressure [ABP] [systolic blood pressure and diastolic blood pressure], ghrelin, leptin and cholesterol were increased while nitric oxide was decreased in pregnancy associated hypertension, pregnancy-induced hypertension [PIH] and preclampsia relative to normal pregnancy. Red blood cells [ABCs], platelets, GFR, HDL were decreased whereas SGOT, SGPT, fasting glucose, proteinuria and BMI were increased in preclampsia relative to other groups. Serum triglycerides and LDL were increased in pregnancy associated hypertension, preclampsia relative to normal pregnancy and PH. However, serum insulin was non significantly changed in all groups. Elevated ghrelin level, in pregnant women suffering from pre-existing chronic hypertension, PIH and preclampsia seems to play an important role in insulin level regulation, energy balance and bodyweight homeostasis, as well as control of cardiac and hemoclynamic functions