Flow mediated vasodilation and circulating concentrations of high sensitive C-reactive protein, interleukin-6 and tumor necrosis factor-alpha in normal pregnancy--The Cardiovascular Risk in Young Finns Study.
BACKGROUND
Traditional risk factors such as hyperlipidemia induce a state of inflammation that impairs vascular function. Despite marked maternal hyperlipidemia, endothelial function improves during pregnancy. In non-pregnant state increased circulating levels of pro-inflammatory cytokines and high sensitive C-reactive protein (hsCRP) lead to attenuated flow mediated vasodilation. Relation between endothelial function and pro-inflammatory cytokines has not been studied thoroughly in pregnancy. The aim of this study was to evaluate the effect of pregnancy on hsCRP and pro-inflammatory cytokines and their associations with vascular endothelial function.


METHODS
As part of population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland we measured brachial artery flow mediated dilation (FMD) and serum concentrations of hsCRP, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in 57 pregnant Finnish women throughout gestation and 62 control women matched for age and smoking.


RESULTS
HsCRP-concentration was greater in pregnancy compared to non-pregnant controls (median hsCRP 2.52 mg l(-1) versus 1.21 mg l(-1), P<0.001). IL-6-concentration was slightly increased in pregnancy compared with the non-pregnant controls (median 1.66 versus 1.32 mg l(-1), non-significant [NS]) and TNF-alpha-concentration was slightly decreased in pregnant group (2.11 versus 2.38 pg ml(-1), NS). FMD increased during pregnancy and IL-6 had a positive correlation to the FMD in pregnancy (R = 0.288, P = 0.031).


CONCLUSIONS
Improvement of FMD in normal pregnancy was not affected by increase in hsCRP concentration. We found an association with IL-6 and FMD but we believe that improvement in endothelial function during normal pregnancy is not caused by variation in hsCRP, IL-6 or TNF-alpha.
Saarelainen
Heli
H
Department of Obstetrics and Gynecology, Kuopio University Hospital, University of Kuopio, Puijonlaaksontie 2, PO box 1777, Kuopio FIN-70211, Finland. heli.saarelainen@kuh.fi
Valtonen
Pirjo
P
Punnonen
Kari
K
Laitinen
Tomi
T
Raitakari
Olli T
OT
Juonala
Markus
M
Heiskanen
Nonna
N
Lyyra-Laitinen
Tiina
T
Viikari
Jorma S A
JS
Heinonen
Seppo
S
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D014664:Vasodilation / Q000502:physiology*
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein