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.	謝幸, 孔北華, 段濤. 婦產科學. 9 版. 北京: 人民衛生出版社, 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.	蔣曉穎, 趙雪卉, 張娟. 妊娠高血壓早期腎損傷情況及其與血清視黃醇結合蛋白、尿酸關系研究. 陜西醫學雜志, 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, 張嫻, 周蓮娥, 等. 血尿酸水平在妊娠期高血壓疾病中的臨床意義. 中國病案, 2021, 22(8): 101-103.
8.	de Mendon?a 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.	溫麗, 郭珍, 胡際東, 等. 漢族女性妊娠期高血壓疾病的流行病學及發病機制研究. 醫學研究雜志, 2017, 46(5): 128-131.
10.	陳方方, 陳春燕, 常青青, 等. 妊娠高血壓疾病胎盤組織中 NGAL 和 sLox-1 的表達及臨床意義. 醫學研究雜志, 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, 胥國強, 蒲澤宴, 等. 青年原發高尿酸血癥氧化應激與炎癥的關系研究. 中國現代醫學雜志, 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. 高尿酸狀態下 NK 細胞、iNK T 細胞亞群及功能變化的研究. 長春: 吉林大學, 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, 湯琳琳, 等. 尿酸及 NLRP3 炎癥小體與妊娠期高血壓的相關性分析. 現代生物醫學進展, 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, 王陽陽, 趙海燕, 等. 妊娠前血尿酸水平與妊娠期高血壓疾病無關. 中華高血壓雜志, 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.	郭凱敏, 林淑君, 許可, 等. 妊娠 20 周前血清指標對妊娠期高血壓疾病發生的預測意義. 熱帶醫學雜志, 2018, 18(6): 783-786.
26.	Ibrahimi L, Pa?arada 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.	許園園. 血清尿酸、白蛋白水平與妊娠期高血壓疾病嚴重程度的相關性分析. 空軍醫學雜志, 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.	馬夢茹, 吳勝軍, 趙宗霞, 等. 子癇前期患者相關生化指標的研究進展. 醫學信息, 2022, 35(22): 176-180.
33.	林靜, 李紅. 妊娠期高血壓疾病孕婦血清尿酸監測的臨床意義. 中國婦產科臨床雜志, 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.	劉志祥, 趙可文, 王興和. C 反應蛋白血尿酸及血脂在各類妊娠期高血壓疾病患者心功能測定中的意義. 河北醫學, 2014(3): 376-380.
39.	肖磊, 劉懷昌, 談炯新, 等. 尿β2-微球蛋白、血清尿酸在妊娠期高血壓疾病早期腎損害的預測作用. 現代診斷與治療, 2018, 29(15): 2433-2435.
40.	邱小軍, 陳英. 血清胱抑素、尿酸、尿微量蛋白與妊娠期高血壓疾病早期腎功能損害的相關性分析. 中國當代醫藥, 2020, 27(11): 170-172.
41.	王錦怡, 鮑珽軼. 血清尿酸及 NLRP3 炎癥小體對妊娠期高血壓疾病孕婦并發急性腎損傷的預測價值. 中華婦幼臨床醫學雜志(電子版), 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. 謝幸, 孔北華, 段濤. 婦產科學. 9 版. 北京: 人民衛生出版社, 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. 蔣曉穎, 趙雪卉, 張娟. 妊娠高血壓早期腎損傷情況及其與血清視黃醇結合蛋白、尿酸關系研究. 陜西醫學雜志, 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, 張嫻, 周蓮娥, 等. 血尿酸水平在妊娠期高血壓疾病中的臨床意義. 中國病案, 2021, 22(8): 101-103.
8. de Mendon?a 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. 溫麗, 郭珍, 胡際東, 等. 漢族女性妊娠期高血壓疾病的流行病學及發病機制研究. 醫學研究雜志, 2017, 46(5): 128-131.
10. 陳方方, 陳春燕, 常青青, 等. 妊娠高血壓疾病胎盤組織中 NGAL 和 sLox-1 的表達及臨床意義. 醫學研究雜志, 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, 胥國強, 蒲澤宴, 等. 青年原發高尿酸血癥氧化應激與炎癥的關系研究. 中國現代醫學雜志, 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. 高尿酸狀態下 NK 細胞、iNK T 細胞亞群及功能變化的研究. 長春: 吉林大學, 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, 湯琳琳, 等. 尿酸及 NLRP3 炎癥小體與妊娠期高血壓的相關性分析. 現代生物醫學進展, 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, 王陽陽, 趙海燕, 等. 妊娠前血尿酸水平與妊娠期高血壓疾病無關. 中華高血壓雜志, 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. 郭凱敏, 林淑君, 許可, 等. 妊娠 20 周前血清指標對妊娠期高血壓疾病發生的預測意義. 熱帶醫學雜志, 2018, 18(6): 783-786.
26. Ibrahimi L, Pa?arada 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. 許園園. 血清尿酸、白蛋白水平與妊娠期高血壓疾病嚴重程度的相關性分析. 空軍醫學雜志, 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. 馬夢茹, 吳勝軍, 趙宗霞, 等. 子癇前期患者相關生化指標的研究進展. 醫學信息, 2022, 35(22): 176-180.
33. 林靜, 李紅. 妊娠期高血壓疾病孕婦血清尿酸監測的臨床意義. 中國婦產科臨床雜志, 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. 劉志祥, 趙可文, 王興和. C 反應蛋白血尿酸及血脂在各類妊娠期高血壓疾病患者心功能測定中的意義. 河北醫學, 2014(3): 376-380.
39. 肖磊, 劉懷昌, 談炯新, 等. 尿β2-微球蛋白、血清尿酸在妊娠期高血壓疾病早期腎損害的預測作用. 現代診斷與治療, 2018, 29(15): 2433-2435.
40. 邱小軍, 陳英. 血清胱抑素、尿酸、尿微量蛋白與妊娠期高血壓疾病早期腎功能損害的相關性分析. 中國當代醫藥, 2020, 27(11): 170-172.
41. 王錦怡, 鮑珽軼. 血清尿酸及 NLRP3 炎癥小體對妊娠期高血壓疾病孕婦并發急性腎損傷的預測價值. 中華婦幼臨床醫學雜志(電子版), 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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