Research progress on the relationship between serum uric acid level and hypertensive disorder of pregnancy_West China Medical Journal

Authors：

ZHANG Xiuying ¹ , ZHANG Jiao ² , HAN Yanhua ³ , JIANG Yue ³ ,  ZHANG Yuehui ³

1. First School of Clinical Medicine, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;
2. Guoyi Hall, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;
3. Department of Gynaecology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;

Corresponding author：

ZHANG Yuehui, Email: chizishui-04@163.com

Keywords：

Hypertensive disorder of pregnancy; serum uric acid; preeclampsia

DOI：

10.7507/1002-0179.202210166

Video：

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Abstract Full text Figures/Tables Video References Cited by

Hypertensive disorder of pregnancy (HDP) is a type of disease unique to women during pregnancy. The most common clinical types are gestational hypertension and preeclampsia, which seriously threaten the health of pregnant women and fetuses. At present, there are no established criteria for the prediction and prevention of HDP. In recent years, a large number of studies have been carried out on HDP around the world, and many studies have shown a close correlation between serum uric acid and HDP. This article reviews the results of existing literature, elucidates the relationship between serum uric acid and the pathogenesis of HDP, prediction of HDP occurrence and development, and adverse pregnancy outcomes.

Citation： ZHANG Xiuying, ZHANG Jiao, HAN Yanhua, JIANG Yue, ZHANG Yuehui. Research progress on the relationship between serum uric acid level and hypertensive disorder of pregnancy. West China Medical Journal, 2023, 38(4): 621-625. doi: 10.7507/1002-0179.202210166 Copy

1.	谢幸, 孔北华, 段涛. 妇产科学. 9 版. 北京: 人民卫生出版社, 2018: 89-94.
2.	Hou Y, Yun L, Zhang L, et al. A risk factor-based predictive model for new-onset hypertension during pregnancy in Chinese Han women. BMC Cardiovasc Disord, 2020, 20(1): 155.
3.	Ives CW, Sinkey R, Rajapreyar I, et al. Preeclampsia-pathophysiology and clinical presentations: JACC state-of-the-art review. J Am Coll Cardiol, 2020, 76(14): 1690-1702.
4.	蒋晓颖, 赵雪卉, 张娟. 妊娠高血压早期肾损伤情况及其与血清视黄醇结合蛋白、尿酸关系研究. 陕西医学杂志, 2021, 50(2): 151-153, 169.
5.	Lv B, Zhang Y, Yuan G, et al. Establishment of a nomogram model for predicting adverse outcomes in advanced-age pregnant women with preterm preeclampsia. BMC Pregnancy Childbirth, 2022, 22(1): 221.
6.	Chen Y, Ou W, Lin D, et al. Increased uric acid, gamma-glutamyl transpeptidase and alkaline phosphatase in early-pregnancy associated with the development of gestational hypertension and preeclampsia. Front Cardiovasc Med, 2021, 8: 756140.
7.	沈霞光, 张娴, 周莲娥, 等. 血尿酸水平在妊娠期高血压疾病中的临床意义. 中国病案, 2021, 22(8): 101-103.
8.	de Mendonça ELSS, da Silva JVF, Mello CS, et al. Serum uric acid levels associated with biochemical parameters linked to preeclampsia severity and to adverse perinatal outcomes. Arch Gynecol Obstet, 2022, 305(6): 1453-1463.
9.	温丽, 郭珍, 胡际东, 等. 汉族女性妊娠期高血压疾病的流行病学及发病机制研究. 医学研究杂志, 2017, 46(5): 128-131.
10.	陈方方, 陈春燕, 常青青, 等. 妊娠高血压疾病胎盘组织中 NGAL 和 sLox-1 的表达及临床意义. 医学研究杂志, 2015, 44(3): 140-142.
11.	Janzarik WG, Ehlers E, Ehmann R, et al. Dynamic cerebral autoregulation in pregnancy and the risk of preeclampsia. Hypertension, 2014, 63(1): 161-166.
12.	Wang W, Sung N, Gilman-Sachs A, et al. T helper (Th) cell profiles in pregnancy and recurrent pregnancy losses: Th1/Th2/Th9/Th17/Th22/Tfh cells. Front Immunol, 2020, 11: 2025.
13.	Aggarwal R, Jain AK, Mittal P, et al. Association of pro- and anti-inflammatory cytokines in preeclampsia. J Clin Lab Anal, 2019, 33(4): e22834.
14.	周游, 胥国强, 蒲泽宴, 等. 青年原发高尿酸血症氧化应激与炎症的关系研究. 中国现代医学杂志, 2017, 27(20): 60-64.
15.	Socha MW, Malinowski B, Puk O, et al. The NLRP3 inflammasome role in the pathogenesis of pregnancy induced hypertension and preeclampsia. Cells, 2020, 9(7): 1642.
16.	高立超. 高尿酸状态下 NK 细胞、iNK T 细胞亚群及功能变化的研究. 长春: 吉林大学, 2019.
17.	Yang X, Yang Y, Yuan Y, et al. The roles of uterine natural killer (NK) cells and KIR/HLA-C combination in the development of preeclampsia: a systematic review. Biomed Res Int, 2020, 2020: 4808072.
18.	王雅萍, 徐友娣, 汤琳琳, 等. 尿酸及 NLRP3 炎症小体与妊娠期高血压的相关性分析. 现代生物医学进展, 2020, 20(1): 85-88, 105.
19.	Brignoni-Pérez E, Dubner SE, Ben-Shachar M, et al. White matter properties underlying reading abilities differ in 8-year-old children born full term and preterm: a multi-modal approach. Neuroimage, 2022, 256: 119240.
20.	Zhang S, Qiu X, Wang T, et al. Hypertensive disorders in pregnancy are associated with congenital heart defects in offspring: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 842878.
21.	Corominas AI, Medina Y, Balconi S, et al. Assessing the role of uric acid as a predictor of preeclampsia. Front Physiol, 2022, 12: 785219.
22.	Zhao X, Frempong ST, Duan T. Uric acid levels in gestational hypertensive women predict preeclampsia and outcome of small-for-gestational-age infants. J Matern Fetal Neonatal Med, 2021, 34(17): 2825-2831.
23.	牛建清, 王阳阳, 赵海燕, 等. 妊娠前血尿酸水平与妊娠期高血压疾病无关. 中华高血压杂志, 2013, 21(8): 732-735.
24.	Kumar N, Singh AK. Maternal serum uric acid as a predictor of severity of hypertensive disorders of pregnancy: a prospective cohort study. Curr Hypertens Rev, 2019, 15(2): 154-160.
25.	郭凯敏, 林淑君, 许可, 等. 妊娠 20 周前血清指标对妊娠期高血压疾病发生的预测意义. 热带医学杂志, 2018, 18(6): 783-786.
26.	Ibrahimi L, Paçarada M, Latifi Hoxha S, et al. Role of calcium/creatinine ratio in urine compared with proteinuria and uric acid in predicting preeclampsia: a study from Kosovo. Med Sci Monit Basic Res, 2021, 27: e929845.
27.	Rezk M, Gaber W, Shaheen A, et al. First versus second trimester mean platelet volume and uric acid for prediction of preeclampsia in women at moderate and low risk. Hypertens Pregnancy, 2018, 37(3): 111-117.
28.	许园园. 血清尿酸、白蛋白水平与妊娠期高血压疾病严重程度的相关性分析. 空军医学杂志, 2019, 35(2): 143-145, 163.
29.	Medjedovic E, Suljevic A, Iglica A, et al. Uric acid values along with doppler sonography findings as a tool for preeclampsia screening. Med Arch, 2019, 73(6): 408-411.
30.	Ryu A, Cho NJ, Kim YS, et al. Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia. Medicine (Baltimore), 2019, 98(18): e15462.
31.	Dogan K, Kural A, Oztoprak Y, et al. Interleukin-1β and uric acid as potential second-trimester predictive biomarkers of preeclampsia. Hypertens Pregnancy, 2021, 40(3): 186-192.
32.	马梦茹, 吴胜军, 赵宗霞, 等. 子痫前期患者相关生化指标的研究进展. 医学信息, 2022, 35(22): 176-180.
33.	林静, 李红. 妊娠期高血压疾病孕妇血清尿酸监测的临床意义. 中国妇产科临床杂志, 2016, 17(6): 546-548.
34.	van Baar PM, Welters SM, Ravelli ACJ, et al. Cardiovascular mortality risk a decade after twin and singleton pregnancies complicated by hypertensive disorders of pregnancy. Pregnancy Hypertens, 2022, 28: 9-14.
35.	Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: long-term consequences for mother and child. Am J Physiol Renal Physiol, 2020, 318(6): F1315-F1326.
36.	Stuart JJ, Tanz LJ, Rimm EB, et al. Cardiovascular risk factors mediate the long-term maternal risk associated with hypertensive disorders of pregnancy. J Am Coll Cardiol, 2022, 79(19): 1901-1913.
37.	Freilich M, Arredondo A, Zonnoor SL, et al. Elevated serum uric acid and cardiovascular disease: a review and potential therapeutic interventions. Cureus, 2022, 14(3): e23582.
38.	刘志祥, 赵可文, 王兴和. C 反应蛋白血尿酸及血脂在各类妊娠期高血压疾病患者心功能测定中的意义. 河北医学, 2014(3): 376-380.
39.	肖磊, 刘怀昌, 谈炯新, 等. 尿β2-微球蛋白、血清尿酸在妊娠期高血压疾病早期肾损害的预测作用. 现代诊断与治疗, 2018, 29(15): 2433-2435.
40.	邱小军, 陈英. 血清胱抑素、尿酸、尿微量蛋白与妊娠期高血压疾病早期肾功能损害的相关性分析. 中国当代医药, 2020, 27(11): 170-172.
41.	王锦怡, 鲍珽轶. 血清尿酸及 NLRP3 炎症小体对妊娠期高血压疾病孕妇并发急性肾损伤的预测价值. 中华妇幼临床医学杂志(电子版), 2021, 17(6): 663-670.
42.	Lin J, Hong XY, Tu RZ. The value of serum uric acid in predicting adverse pregnancy outcomes of women with hypertensive disorders of pregnancy. Ginekol Pol, 2018, 89(7): 375-380.
43.	Le TM, Nguyen LH, Phan NL, et al. Maternal serum uric acid concentration and pregnancy outcomes in women with pre-eclampsia/eclampsia. Int J Gynaecol Obstet, 2019, 144(1): 21-26.
44.	Ayankunle OM, Adeniyi AA, Adewara OE, et al. Maternal serum uric acid: a reliable prognostic indicator of foetal outcome among pre-eclamptic patients in a low resource setting. J Matern Fetal Neonatal Med, 2022, 35(25): 7695-7700.
45.	Kumar N, Singh AK. Maternal serum uric acid and calcium as predictors of hypertensive disorder of pregnancy: a case control study. Taiwan J Obstet Gynecol, 2019, 58(2): 244-250.

1. 谢幸, 孔北华, 段涛. 妇产科学. 9 版. 北京: 人民卫生出版社, 2018: 89-94.
2. Hou Y, Yun L, Zhang L, et al. A risk factor-based predictive model for new-onset hypertension during pregnancy in Chinese Han women. BMC Cardiovasc Disord, 2020, 20(1): 155.
3. Ives CW, Sinkey R, Rajapreyar I, et al. Preeclampsia-pathophysiology and clinical presentations: JACC state-of-the-art review. J Am Coll Cardiol, 2020, 76(14): 1690-1702.
4. 蒋晓颖, 赵雪卉, 张娟. 妊娠高血压早期肾损伤情况及其与血清视黄醇结合蛋白、尿酸关系研究. 陕西医学杂志, 2021, 50(2): 151-153, 169.
5. Lv B, Zhang Y, Yuan G, et al. Establishment of a nomogram model for predicting adverse outcomes in advanced-age pregnant women with preterm preeclampsia. BMC Pregnancy Childbirth, 2022, 22(1): 221.
6. Chen Y, Ou W, Lin D, et al. Increased uric acid, gamma-glutamyl transpeptidase and alkaline phosphatase in early-pregnancy associated with the development of gestational hypertension and preeclampsia. Front Cardiovasc Med, 2021, 8: 756140.
7. 沈霞光, 张娴, 周莲娥, 等. 血尿酸水平在妊娠期高血压疾病中的临床意义. 中国病案, 2021, 22(8): 101-103.
8. de Mendonça ELSS, da Silva JVF, Mello CS, et al. Serum uric acid levels associated with biochemical parameters linked to preeclampsia severity and to adverse perinatal outcomes. Arch Gynecol Obstet, 2022, 305(6): 1453-1463.
9. 温丽, 郭珍, 胡际东, 等. 汉族女性妊娠期高血压疾病的流行病学及发病机制研究. 医学研究杂志, 2017, 46(5): 128-131.
10. 陈方方, 陈春燕, 常青青, 等. 妊娠高血压疾病胎盘组织中 NGAL 和 sLox-1 的表达及临床意义. 医学研究杂志, 2015, 44(3): 140-142.
11. Janzarik WG, Ehlers E, Ehmann R, et al. Dynamic cerebral autoregulation in pregnancy and the risk of preeclampsia. Hypertension, 2014, 63(1): 161-166.
12. Wang W, Sung N, Gilman-Sachs A, et al. T helper (Th) cell profiles in pregnancy and recurrent pregnancy losses: Th1/Th2/Th9/Th17/Th22/Tfh cells. Front Immunol, 2020, 11: 2025.
13. Aggarwal R, Jain AK, Mittal P, et al. Association of pro- and anti-inflammatory cytokines in preeclampsia. J Clin Lab Anal, 2019, 33(4): e22834.
14. 周游, 胥国强, 蒲泽宴, 等. 青年原发高尿酸血症氧化应激与炎症的关系研究. 中国现代医学杂志, 2017, 27(20): 60-64.
15. Socha MW, Malinowski B, Puk O, et al. The NLRP3 inflammasome role in the pathogenesis of pregnancy induced hypertension and preeclampsia. Cells, 2020, 9(7): 1642.
16. 高立超. 高尿酸状态下 NK 细胞、iNK T 细胞亚群及功能变化的研究. 长春: 吉林大学, 2019.
17. Yang X, Yang Y, Yuan Y, et al. The roles of uterine natural killer (NK) cells and KIR/HLA-C combination in the development of preeclampsia: a systematic review. Biomed Res Int, 2020, 2020: 4808072.
18. 王雅萍, 徐友娣, 汤琳琳, 等. 尿酸及 NLRP3 炎症小体与妊娠期高血压的相关性分析. 现代生物医学进展, 2020, 20(1): 85-88, 105.
19. Brignoni-Pérez E, Dubner SE, Ben-Shachar M, et al. White matter properties underlying reading abilities differ in 8-year-old children born full term and preterm: a multi-modal approach. Neuroimage, 2022, 256: 119240.
20. Zhang S, Qiu X, Wang T, et al. Hypertensive disorders in pregnancy are associated with congenital heart defects in offspring: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 842878.
21. Corominas AI, Medina Y, Balconi S, et al. Assessing the role of uric acid as a predictor of preeclampsia. Front Physiol, 2022, 12: 785219.
22. Zhao X, Frempong ST, Duan T. Uric acid levels in gestational hypertensive women predict preeclampsia and outcome of small-for-gestational-age infants. J Matern Fetal Neonatal Med, 2021, 34(17): 2825-2831.
23. 牛建清, 王阳阳, 赵海燕, 等. 妊娠前血尿酸水平与妊娠期高血压疾病无关. 中华高血压杂志, 2013, 21(8): 732-735.
24. Kumar N, Singh AK. Maternal serum uric acid as a predictor of severity of hypertensive disorders of pregnancy: a prospective cohort study. Curr Hypertens Rev, 2019, 15(2): 154-160.
25. 郭凯敏, 林淑君, 许可, 等. 妊娠 20 周前血清指标对妊娠期高血压疾病发生的预测意义. 热带医学杂志, 2018, 18(6): 783-786.
26. Ibrahimi L, Paçarada M, Latifi Hoxha S, et al. Role of calcium/creatinine ratio in urine compared with proteinuria and uric acid in predicting preeclampsia: a study from Kosovo. Med Sci Monit Basic Res, 2021, 27: e929845.
27. Rezk M, Gaber W, Shaheen A, et al. First versus second trimester mean platelet volume and uric acid for prediction of preeclampsia in women at moderate and low risk. Hypertens Pregnancy, 2018, 37(3): 111-117.
28. 许园园. 血清尿酸、白蛋白水平与妊娠期高血压疾病严重程度的相关性分析. 空军医学杂志, 2019, 35(2): 143-145, 163.
29. Medjedovic E, Suljevic A, Iglica A, et al. Uric acid values along with doppler sonography findings as a tool for preeclampsia screening. Med Arch, 2019, 73(6): 408-411.
30. Ryu A, Cho NJ, Kim YS, et al. Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia. Medicine (Baltimore), 2019, 98(18): e15462.
31. Dogan K, Kural A, Oztoprak Y, et al. Interleukin-1β and uric acid as potential second-trimester predictive biomarkers of preeclampsia. Hypertens Pregnancy, 2021, 40(3): 186-192.
32. 马梦茹, 吴胜军, 赵宗霞, 等. 子痫前期患者相关生化指标的研究进展. 医学信息, 2022, 35(22): 176-180.
33. 林静, 李红. 妊娠期高血压疾病孕妇血清尿酸监测的临床意义. 中国妇产科临床杂志, 2016, 17(6): 546-548.
34. van Baar PM, Welters SM, Ravelli ACJ, et al. Cardiovascular mortality risk a decade after twin and singleton pregnancies complicated by hypertensive disorders of pregnancy. Pregnancy Hypertens, 2022, 28: 9-14.
35. Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: long-term consequences for mother and child. Am J Physiol Renal Physiol, 2020, 318(6): F1315-F1326.
36. Stuart JJ, Tanz LJ, Rimm EB, et al. Cardiovascular risk factors mediate the long-term maternal risk associated with hypertensive disorders of pregnancy. J Am Coll Cardiol, 2022, 79(19): 1901-1913.
37. Freilich M, Arredondo A, Zonnoor SL, et al. Elevated serum uric acid and cardiovascular disease: a review and potential therapeutic interventions. Cureus, 2022, 14(3): e23582.
38. 刘志祥, 赵可文, 王兴和. C 反应蛋白血尿酸及血脂在各类妊娠期高血压疾病患者心功能测定中的意义. 河北医学, 2014(3): 376-380.
39. 肖磊, 刘怀昌, 谈炯新, 等. 尿β2-微球蛋白、血清尿酸在妊娠期高血压疾病早期肾损害的预测作用. 现代诊断与治疗, 2018, 29(15): 2433-2435.
40. 邱小军, 陈英. 血清胱抑素、尿酸、尿微量蛋白与妊娠期高血压疾病早期肾功能损害的相关性分析. 中国当代医药, 2020, 27(11): 170-172.
41. 王锦怡, 鲍珽轶. 血清尿酸及 NLRP3 炎症小体对妊娠期高血压疾病孕妇并发急性肾损伤的预测价值. 中华妇幼临床医学杂志(电子版), 2021, 17(6): 663-670.
42. Lin J, Hong XY, Tu RZ. The value of serum uric acid in predicting adverse pregnancy outcomes of women with hypertensive disorders of pregnancy. Ginekol Pol, 2018, 89(7): 375-380.
43. Le TM, Nguyen LH, Phan NL, et al. Maternal serum uric acid concentration and pregnancy outcomes in women with pre-eclampsia/eclampsia. Int J Gynaecol Obstet, 2019, 144(1): 21-26.
44. Ayankunle OM, Adeniyi AA, Adewara OE, et al. Maternal serum uric acid: a reliable prognostic indicator of foetal outcome among pre-eclamptic patients in a low resource setting. J Matern Fetal Neonatal Med, 2022, 35(25): 7695-7700.
45. Kumar N, Singh AK. Maternal serum uric acid and calcium as predictors of hypertensive disorder of pregnancy: a case control study. Taiwan J Obstet Gynecol, 2019, 58(2): 244-250.

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