Biomarkers of purine metabolism and beta-2-microglobulin in pregnant women with severe arterial hypertension in the third trimester: predictors of complications
DOI:
https://doi.org/10.37800/RM.3.2025.531Keywords:
beta-2-microglobulin (B2M), purine intermediates, chronic arterial hypertension (CAH), pregnancy, oxidative stressAbstract
Relevance: Severe chronic arterial hypertension (CAH) in pregnant women increases the risk of complications for both mother and fetus, partly due to oxidative stress associated with impaired purine metabolism and immune activation. Beta-2-microglobulin (B2M) and purine intermediates (guanine, hypoxanthine, adenine, xanthine, and uric acid) may be markers of these processes.
The study aimed to compare the levels of B2M and purine intermediates in erythrocytes and plasma of pregnant women with severe CAH and healthy women in the third trimester, investigate their correlations with clinical parameters, and identify CAH predictors.
Materials and methods: A retrospective cross-sectional study included 58 gravidas in their third trimester: 29 with severe CAH (Group 1) and 29 conditionally healthy women (Group 4). The Mann-Whitney U test, Spearman correlation, binary logistic regression, and ROC analysis were used.
Results: Group 1 had elevated levels of B2M (2.64 ± 0.47 vs. 1.58 ± 0.29 mg/L; p<0.001), erythrocyte guanine (395.2 ± 112.3 vs. 309.6 ± 95.8 nmol/L; p = 0.002), erythrocyte uric acid (111.7 ± 40.2 vs. 80.5 ± 21.7 nmol/L; p = 0.004) and plasma hypoxanthine (252.6 ± 135.8 vs. 181.3 ± 94.6 nmol/L; p = 0.012). Strong correlations were found between B2M and erythrocyte guanine (ρ = 0.45, p<0.001), as well as between B2M and systolic blood pressure (ρ = 0.41, p = 0.002). B2M (OR = 2.1; 95% CI: 1.3-3.4) and erythrocyte guanine (OR = 1.8; 95% CI: 1.1-2.9) were independent predictors of CAH.
Conclusion: B2M and purine intermediates, especially guanine and uric acid in red blood cells, are promising biomarkers for monitoring severe CAH, reflecting oxidative and immune stress. Their use may facilitate risk stratification and personalized treatment.
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