Niveles séricos del factor neurotrófico derivado del cerebro durante la gestación normal y la preeclampsia
Serum Levels of Brain Derived Neurotrophic Factor during Normal Pregnancy and Preeclampsia
Palabras clave:
Preeclampsia, Factor neurotrófico derivado del encéfalo, Embarazo (es)Pre-Eclampsia, Brain-Derived Neurotrophic Factor, Pregnancy (en)
Introducción. La preeclampsia (PE) es una de las principales causas de mortalidad materna y perinatal en el mundo, aparece en la segunda mitad de la gestación y actualmente no hay marcadores que la detecten en forma temprana. Dadas las propiedades angiogénicas del factor neurotrófico derivado del cerebro (BDNF) y la disfunción endotelial de los vasos sanguíneos presente en la PE, se ha propuesto una posible asociación entre el BDNF y PE.
Objetivo. Determinar si existe asociación entre niveles séricos de BDNF durante el embarazo y la preeclampsia.
Materiales y métodos. Estudio de cohorte prospectivo longitudinal. Se seleccionaron 13 pacientes quienes desarrollaron PE y 31 gestantes de curso normal. Se midieron variables antropométricas y niveles de BDNF, glicemia, insulina y perfil lipídico en la gestación temprana, media y tardía. Se practicó un modelo de regresión logística para verificar si los niveles de BDNF, en conjunto con otras variables, pueden explicar el desarrollo de PE.
Resultados. Los niveles de BDNF no variaron significativamente entre el grupo de gestantes que desarrollaron preeclampsia y las que no: en gestación temprana 25.3 y 23.3ng/ml, en gestación media 28 y 24.7ng/ml y en gestación tardía 25.4 y 27.4ng/ml, respectivamente. Se hallaron diferencias entre los dos grupos en el peso, la insulina y la evaluación del modelo homeostático (HOMA). Se encontró asociación entre niveles de BDNF y peso e IMC y glucemia en las gestantes que no desarrollaron PE. Se practicó un modelo de regresión logística en el que la PE se explicó mejor con variables como IMC, PAS y HOMA, pero no con BDNF.
Conclusiones. El BDNF puede participar en la regulación del peso corporal y el metabolismo de la glucosa en mujeres gestantes, pero el nivel de BDNF, solo o en conjunto con otras variables, no puede explicar la preeclampsia.
Introduction. Preeclampsia (PE) is one of the major causes of maternal and perinatal mortality in the world. PE appears during the second half of pregnancy and there are currently no markers for its early detection. Given the angiogenic properties of brain derived neurotrophic factor (BDNF) and the endothelial dysfunction of blood vessels that occurs during PE, an association between BDNF and PE has been proposed.
Objective. To determine if there is an association between BDNF serum levels and PE during pregnancy.
Materials and Methods. Prospective longitudinal cohort study. 13 patients who developed PE and 31 patients with normally coursing pregnancies were selected. Anthropometric variables, BDNF serum levels, glycemia, insulin and lipid profile in early, mid-term and late pregnancies were measured.
Results. No significant differences were observed in BDNF levels between women who developed PE and those who did not; in early pregnancy the levels were 25.3 and 23.3 ng/ml, for mid-term pregnancy 28 and 24.7 ng/ml and for late pregnancy 25.4 and 27.4 ng/ml for PE and normal pregnancy, respectively. An association between BDNF and weight and BMI and serum glucose was found in women who did not develop PE. A logistic regression model was carried out where PE was better explained through variables such as BMI, SBP and homoeostasis model assessment (HOMA), however BDNF was not taken into account here.
Conclusions. BDNF might have a role in regulating body weight and glucose metabolism in pregnant women but there is no evidence to suggest that BDNF alone or in combination with other variables can account for PE.
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Steegers E, Von Dadelszen P, Duvekot J, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631-44. http://doi.org/d3cbtp.
American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global Causes of Maternal Death: a WHO Systematic Analysis. Lancet Glob Health. 2014;2(6):e323-33. http://doi.org/bf35.
Ministerio de Salud y Protección Social de Colombia, Dirección de Epidemiología y Demografía, Grupo asís. Análisis de Situación de Salud según regiones Colombia. Bogotá, D.C.: MinSalud; 2013.
Ziniga FA, Ormazabal V, Gutiérrez N, Aguilera V, Radojkovic C, Veas C, et al. Role of lectin-like oxidized low density lipoprotein-1 in fetoplacental vascular dysfunction in preeclampsia. Biomed Res. Int. 2014;2014:353-616. http://doi.org/bf36.
Álvarez-Díaz A, Rodríguez EH, editors. Revisiones en Biología celular y molecular. Bilbao: Servicio Editorial de la Universidad del País Vasco; 2010.
Guzeloglu-Kayisli O, Kayisli UA, Taylor HS. The Role of Growth Factors and Cytokines during Implantation: Endocrine and Paracrine Interactions. Semin. Reprod. Med. 2009;27(1):62-79. http://doi.org/fhv5hf.
Reichardt LF. Neurotrophin-regulated signalling pathways. Philos. Trans. R. Soc. Lond. B. Biol. Sci. 2006;361(1473):1545-64. http://doi.org/d8gw5t.
Huang EJ, Reichardt LF. Trk receptors: Roles in neuronal signal transduction. Annu. Rev. Biochem. 2003;72:609-42. http://doi.org/dnt7zf.
Kawamura K, Kawamura N, Fukuda J, Kumagai J, Hsueh AJ, Tanaka T. Regulation of preimplantation embryo development by brain-derived neurotrophic factor. Dev. Biol. 2007;311(1):147-58. http://doi.org/fcn49w.
Kawamura K, Kawamura N, Sato W, Fukuda J, Kumagai J, Tanaka T. Brain-derived neurotrophic factor promotes implantation and subsequent placental development by stimulating trophoblast cell growth and survival. Endocrinology. 2009;150(8):3774-82. http://doi.org/c8bnqq.
Fujita K, Tatsumi K, Kondoh E, Chigusa Y, Mogami H, Fujii T, et al. Differential expression and the anti-apoptotic effect of human placental neurotrophins and their receptors. Placenta. 2011;32(10):737-44. http://doi.org/fsxv4t.
Rios M. BDNF and the central control of feeding: accidental bystander or essential player? Trends Neurosci. 2012;36(2):83-90. http://doi.org/bf38.
D'Souzaa V, Patila V, Pisala H, Randhira K, Joshia A, Mehendaleb S, et al. Levels of brain derived neurotrophic factors across gestation in women with preeclampsia. Int. J. Dev. Neurosci. 2014;37:36-40. http://doi.org/bf39.
BDNF Human ELISA Kit (ab99978). Cambridge: Abcam discover more. [cited 2014 Sep 30]. Available from: http://goo.gl/ZZC0vN.
Stekkinger E, Scholten R, van der Vlugt MJ, van Dijk AP, Janssen MC, Spaanderman ME. Metabolic syndrome and the risk for recurrent pre-eclampsia: a retrospective cohort study. BJOG. 2013;120(8):979-86. http://doi.org/bf4b.
Hermes W, Franx A, van Pampus MG, Bloemenkamp KW, Bots ML, van der Post JA, et al. Cardiovascular risk factors in women who had hypertensive disorders late in pregnancy: a cohort study. Am. J. Clin. Exp. Obstet. Gynecol. 2013;208(6):474.e1-8.
Hoirisch-Clapauch S, Benchimol-Barbosa PR. Markers of insulin resistance and sedentary lifestyle are predictors of preeclampsia in women with adverse obstetric results. Braz. J. Med. Biol. Res. 2011;44(12):1285-90. http://doi.org/dnr3pd.
Morteza A, Abdollahi A, Bandarian M. Serum nitric oxide syntheses and lipid profile of the mothers with IUGR pregnancies uncomplicated with preeclampsia. Does insulin resistance matter? Gynecol. Endocrinol. 2012;28(2):139-42. http://doi.org/cq5bfk.
Gaillard R, Durmuş B, Hofman A, Mackenbach JP, Steegers EA, Jaddoe VW. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity (Silver Spring). 2013;21(5):1046-55. http://doi.org/bf4c.
Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr. Rev. 2013;71(Suppl 1):S18-25. http://doi.org/bf4d.
Bigelow CA, Pereira GA, Warmsley A, Cohen J, Getrajdman C, Moshier E, et al. Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia. Am. J. Obstet. Gynecol. 2014;210(4):338.e1-8. http://doi.org/f2qtnh.
Roberts JM, Bodnar LM, Patrick TE, Powers RW. The Role of Obesity in Preeclampsia. Pregnancy Hypertens. 2011;1(1):6-16. http://doi.org/d3qcr8.
Marosi K, Mattson MP. BDNF mediates adaptive brain and body responses to energetic challenges. Trends Endocrinol. Metab. 2014;25(2):89-98. http://doi.org/bf4f.
Shu X, Zhang Y, Xu H, Kang K, Cai D. Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia. Neural Regen. Res. 2013;8(25):2370-8. http://doi.org/bf4g.
Fujinamia A, Ohtab K, Obayashic H, Fukuid M, Hasegawad G, Nakamurad N, et al. Serum brain-derived neurotrophic factor in patients with type 2 diabetes mellitus: Relationship to glucose metabolism and biomarkers of insulin resistance. Clin. Biochem. 2008;41(10-11):812-7. http://doi.org/bn9nb6.
Cordeira J, Rios M. Weighing in the role of BDNF in the central control of eating behavior. Mol. Neurobiol. 2011;44(3):441-8. http://doi.org/bbxvz9.
Zhang XY, Zhou DF, Wu GY, Cao LY, Tan YL, Haile CN, et al. BDNF levels and genotype are associated with antipsychotic-induced weight gain in patients with chronic schizophrenia. Neuropsychopharmacology. 2008;33(9):2200-5. http://doi.org/dr2kt3.
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