The Role of Personalized Preventive Medicine in Reproductive Risk Regulation

Abstract

Despite some success in the study of pre-eclampsia, it is still one of the main causes in the structure of maternal mortality. The tissues of the reproductive organs: ovaries, uterus, placenta, testis and pituitary have the receptors for vitamin D, and the association of vitamin D role with reproductive health is evident. The aim of the study was to study the effect of vitamin D deficiency on renin concentration among pregnant women from the groups of preeclampsia development risk. The pregnant women with pre-eclampsia and the patients with a high risk of preeclampsia development who are planning pregnancy were studied for vitamin D, endothelin and renin concentrations, since it is known from literature data that enzymes like renin are found in the uterus, placenta and in the walls of some large arteries. The material of the study was blood. The method of enzyme immunoassay and the sets of biomedicagruppe (Germany) were used to determine the availability of vitamin D, the enzyme immunoassay and Immuno Chem (USA) sets were used to determine the renin concentration. The patients with developed preeclampsia showed highly reliable correlations between low vitamin D values and high blood pressure (r = 0.68, p < 0.01), high endothelin level in blood (r = 0.56, p < 0.01), high renin concentration (r = 0.72, p < 0.01), an early onset of PE (r = 0.46 p < 0.05). The risk group of pre-eclampsia development among the women planning a pregnancy was composed of 30 women with hypertension, 31 - with kidney disease, 24 - with obesity (BMI > 34), 13 - with body weight deficit. The supply of vitamin D and the level of ionized Ca among these women were significantly lower (0.07 ± 0.01 mmol/l) than among the women not included in risk group (1.2 ± 0.02 mmol/l); the renin concentration exceeded the mean values among the women of the control group. The patients with hypertension and obesity had the renin concentration at the upper limit of physiological parameters (30.4 ± 1.8 and 28.4 ± 1.6 pg/ml, respectively), and the level of vitamin D was lower than in other nosologies among the patients of high risk group (14.8 ± 1.5 and 13.9 ± 1.5 ng/ml, respectively). At renal diseases and body mass deficiency, the renin concentration was 16.6 ± 0.7 and 12.4 ± 0.8 pg/ml, respectively, while the level of vitamin D was 17.4 ± 1.5 and 16.9 ± 1.2 ng/ml.