Study On The Role Of Leptin And Estrogen Receptor In Hypertensive Disorders In Pregnancy

Objective: Hypertensive disorder complicating pregnancy(HDCP) is apregnancy-specific disease of woman, which leads to the main cause for thedeath of pregnancies and neonates. A serious threat to the pregnancies andneonates health.But up to the date,the clear to etiology of hypertensivedisorder complicating pregnancy is unknown.Now that the development ofresearch HDCP are many factors,may act together,compared to immunitydamage, shallow placental implantation, placental vascular recastbarrier,vascular endothelial damage,nutritional deficiency,genetic factors andinsulin resistance,number of studies show that the Leptin resistance with theLeptin resistance, Leptin resistance to pancreatic islet β-cell affectedendocrine axle of fat-insulin the cause of high blood insulin happened.estrogen is the major hormone secreted by the gestation period of pregnancy，estrogen by estrogen receptor’s mediation expressing biological effect,estrogen receptor can maintain normal vascular’s function, expand the bloodvessels and lower blood pressure. Through studying characteristics andrelativity among Leptin and Estrogen Receptor in placenta of hypertensivedisorders in pregnancy,we hope provide the evidence of experiment theoriesfor clinical treatment.Methods:160women with hyptensive disorders in pregnancy(30lightpreeclampsia,30severe preeclampsia)and30women with normal pregnancywere recruited the fourth affiliated hospital of Hebei medical university asstudy group and control group from2010to2011. Respectively, the twogroups excepted other disease were maternal age, party gestational age.Sample collecting: About l×l×lcm placental tissues were collected from thepregnant women after the placenta was deliveried in30minutes. Use axenic 0.9%sodium chloride to wash it and fix it with formaldehyde.2The expression of Leptin and estrogen receptor(ER) in placenta wasdetected by immuno-histochemical SP method.3The data was analyzed by SPSS13.0software wrap, Chi-squaretests,Kruskal-wallis H Test, Wilcoxon signed-rank test and Spearman graderelation analysis are involved. Statistically significant level was consideredas“alpha equals0.05”and “P<0.01” indicating very significant difference.Results:1The comparison of clinical general information: the average age ofpatients and gestation age in each group were not statisticallysignificant(P>0.05).2HE staining:Normal placentaes of pregnant women:villus with rish blood vessels,insterstitial less, the volume is normal, and small arterial walls are smooth inplacental villus and deciduas.The mild preeclampsia and severe preeclampsia group placentaes:theplacenta villus ascular bed density decreases,interstitial hyperplasia intonodules sample,villus in placenta are swelling.At the same time,small arteriehas the emergence of acute atherosclerotic change,with infiltration oflymphocytes.3the expression of Leptin3.1Immunohistochemical staining for Leptin in the experimental groupand control group shows the location in the placenta difference was notsignificant meaning,are diffuse distribution in placenta cell membranenourish cells cytoplasm and nuclear membrane.The expression of Leptin introphocyte showed significant higher in light preeclampsia group (positiverate=80%) than in control group (positive rate=26.67%),p<0.05. Theexpression of Leptin in trophocyte showed significant higher in severepreeclampsia group (positive rate=96.67%) than in control group (positiverate=26.67%),p<0.05.3.2The expression of Leptin is different from severe preeclampsia group and light preeclampsia group to control group,there is statisticsignificant(Hc=19.879,p=0.000<0.05).The expression of Leptin in lightpreeclampsia group is higher than that in controlgroup(Z=-4.255,p=0.000<0.05). The expression of Leptin in severepreeclampsia group is higher than that in controlgroup(Z=-5.994,p=0.000<0.05).The expression of Leptin showedsignificances correlated with the degree of differentiation: The expression ofLeptin in light preeclampsia group is lower than that in severe preeclampsiagroup(Z=-3.061,p=0.002<0.05).4the expression of ER4.1Immunohistochemical staining for ER in the experimental group andcontrol group shows the location in the placenta difference was notsignificant meaning, mainly express in the placenta villous trophoblastic themembrane of cells, cytoplasm have a small amount of expression,nourishcells of cell membrane and cytoplasm also have the ER expression. Theexpression of ER in trophocyte showed significant lower in lightpreeclampsia group (positive rate=83.33%) than in control group (positiverate=100%),p<0.05. The expression of ER in trophocyte showed significantlower in severe preeclampsia group (positive rate=40%) than in control group(positive rate=100%),p<0.05.4.2The expression of ER is different from severe preeclampsia group andlight preeclampsia group to control group,there is statisticsignificant(Hc=7.449,p=0.024<0.05).The expression of ER in lightpreeclampsia group is lower than that in controlgroup(Z=-4.625,p=0.000<0.05). The expression of ER in severepreeclampsia group is lower than that in controlgroup(Z=-5.948,p=0.000<0.05).The expression of ER showedsignificances correlated with the degree of differentiation: The expression ofER in severe preeclampsia group is lower than that in light preeclampsiagroup(Z=-3.105,p=0.002<0.05).5The expression degree of Leptin and ER was negative correlate to the degree of hypertensive disorders in pregnancy.Conclusion:1Leptin and ER are different express in control group, light preeclampsiagroup and severe preeclampsia group.2With the development of hypertensive disorders in pregnancy, theexpression level of Leptin in placenta gradually raised, cause insulin resistanceand maternal suger lipid metabolism disorders may participate in Hypertensivedisorder complicating pregnancy.3With the development of hypertensive disorders in pregnancy, theexpression level of ER in placenta gradually decreases,make its maintainnormal vascular’s function, expand the blood vessels and lower blood pressurerole reduced, may participate in Hypertensive disorder complicatingpregnancy.4Hypertensive disorder complicating pregnancy with higher expressionlevel of Leptin in placenta lead to shallow placental implantation and placentahypoxia cause estrogen secretes inadequacy, estrogen receptor downregulation. The common participate in Hypertensive disorder complicatingpregnancy’s happening and development.