title: Glucocorticoid Metabolism in Hypertensive Disorders of Pregnancy: Analysis of Plasma and Urinary Cortisol and Cortisone.
abstract: OBJECTIVE
  The aim of the study was to analyze the plasma and urinary cortisol (F) and cortisone (E) levels in normotensive and hypertensive pregnant women. The parameters known to reflect the function of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) were calculated to verify the changes in glucocorticoid balance over the course of gestational hypertension (GH) and pre-eclampsia (PE).
  
  
  METHODS
  This retrospective case-control study included women in the third trimester of pregnancy, diagnosed with: GH (n = 29), PE (n = 26), or chronic hypertension (CH; n = 22). Normotensive women in their third trimester of pregnancy were also included (controls; n = 43). The plasma and urinary F and E levels were measured with the HPLC-FLD method. The 11β-HSD2 function was estimated by calculating the following ratios: plasma F/E and urinary free F to urinary free E (UFF/UFE). A statistical analysis was performed based on case-control structure.
  
  
  CONCLUSIONS
  PE was characterized by lower plasma F levels (639.0 nmol/L), UFF/Cr levels (3.80 μg/mmol) and F/E ratio (3.46) compared with that of the controls (811.7 nmol/L, 6.28 μg/mmol and 5.19, respectively) with marked abnormalities observed in the changes of F/E and UFF/UFE ratios with advancing gestation. GH patients showed significant disparities in the urinary steroid profile with lower UFF/UFE ratio (0.330 vs. 0.401) compared with the normotensive controls and abnormal changes in the UFF/UFE throughout pregnancy. The observed tendency towards lower F/E and UFF/UFE ratios in PE and GH patients may reflect more intensive F metabolism over the course of those disorders. In the normal pregnancy group, the plasma F/E and UFF/UFE ratios tended to present inverse correlations with advancing gestation. This trend was much less marked in PE and GH patients, suggesting that the abnormalities in 11β-HSD2 functions progressed with the GA. The birth weights of neonates born from pre-eclamptic pregnancies were lower than those from uncomplicated pregnancies, although only when the babies were born prematurely. Children born at term to normotensive mothers or mothers suffering from PE had comparable birth weights.
authors.affiliation: Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kosicka
authors.affiliation: Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Siemiątkowska
authors.affiliation: Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Mariola
authors.initials: M
authors.lastname: Krzyścin
authors.affiliation: Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Grzegorz H
authors.initials: GH
authors.lastname: Bręborowicz
authors.affiliation: Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Matylda
authors.initials: M
authors.lastname: Resztak
authors.affiliation: Department of Pharmaceutical Biochemistry, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Majchrzak-Celińska
authors.affiliation: Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Chuchracki
authors.affiliation: Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Franciszek K
authors.initials: FK
authors.lastname: Główka
mesh_terms: D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2 / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D003348:Cortisone / Q000097:blood / Q000652:urine; D005260:Female; D005938:Glucocorticoids / Q000097:blood / Q000652:urine; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D011225:Pre-Eclampsia / Q000097:blood / Q000652:urine; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids; D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2; D003348:Cortisone; D006854:Hydrocortisone