The Association of Serum Androgen Levels with Preeclampsia

Mudher Al-Hilli, Nadia; Hashim Al-Shalah, Haydar

	The Association of Serum Androgen Levels with Preeclampsia
Medical Journal of Babylon
Article 1, Volume 7, Issue 1, 2010, Pages 58-66
Authors
Nadia Mudher Al-Hilli; Haydar Hashim Al-Shalah
Abstract
Background: Preeclampsia is a major cause of morbidity and mortality during pregnancy. Several independent investigators have demonstrated the association of androgens with hypertension. Objective:To determine whether maternal serum levels of testosterone and dehydroepiandrosterone sulphate DHEA-S, are higher in patients with preeclampsia than in matched normotensive control subjects. Method: Case control study included 29 subjects in the 3rd trimester of pregnancy with documented preeclampsia (including 10 cases of mild and19 cases of severe preeclampsia) and 20 healthy normotensive women in the third trimester of pregnancy used as control group and for comparative purpose another 13 patients with gestational hypertension were also included in our study. All cases had singleton pregnancies. Cases of polycystic ovary syndrome (PCOS), diabetes, chronic hypertension and chronic systemic diseases such as lupus and patients using steroid drugs were excluded. Serum levels of total testosterone were measured using testosterone enzyme immunoassay test kit, Biocheck (USA), while dehydroepiandrosterone sulfate (DHEA-S) was measured using DHEA-S enzyme immunoassay test kit, DRG (USA, Germany). Results: Student t-test was used to analyze the difference in androgen levels between the different groups. Serum total testosterone level was significantly higher in patients with severe pre-eclampsia compared to control group (0.41ng/mL versus 0.31ng/mL, P value 0.005), while no significant difference was found between cases of mild and severe pre-eclampsia. Again no significant difference was found when comparing patients with mild pre-eclampsia with control group and cases of gestational hypertension with control group. Serum level of dehydroepiandrosterone sulfate (DHEA-S) was significantly higher in patients with severe pre-eclampsia compared to patients with mild pre-eclampsia (1.03 µg/mL versus 0.32 µg/mL; P value 0.005) and when compared with control group (1.03 µg/mL versus 0.59 µg/mL; P value 0.02), while the level was not significantly higher when comparing cases of mild pre-eclampsia with control group and cases of gestational hypertension with control group. Conclusion: Levels of total testosterone and dehydroepiandrosterone sulfate (DHEA-S) were significantly higher in women with severe preeclampsia than in normotensive women. The levels of these androgens were higher in women severe pre-eclampsia when compared to women with mild pre-eclampsia and those with gestational hypertension. This difference may indicate a role for androgens in the pathogenesis of preeclampsia and stimulates research in the potential role of anti-androgens in the management of preeclampsia.

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