Inflammatory Mediators (CA125, CRP) and Uric Acid in Association with Severity of Preeclampsia in North Kordofan State, Western Sudan
Naglaa Abdelbasit Suliman
Department of Biochmistry, Faculty of Medicine, University of Kordofan, Sudan.
Khidir Elamin Awadalla
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kordofan, Sudan.
Khalid Hussein Bakheit *
Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Kingdom of Saudi Arabia.
Abdelrahim Osman Mohamed
Department of Biochemistry, Faculty of Medicine, University of Khartoum, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Inflammatory mediators could be laboratory markers of preeclampsia, as the induction of an inflammatory process within the placenta may trigger the expression of cancer antigen 125(CA125), C-reactive protein (CRP) and uric acid (UA). Regarding the pathophysiology of pre-eclampsia, there is defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia, and induction of an inflammatory process within the placenta.
Objective: To evaluate the association of serum levels of cancer antigen (CA125), C-reactive protein (CRP) and serum uric acid with the Severity of Preeclampsia.
Materials and Methods: The study recruited 200 singleton Sudanese pregnant women. These participants were divided into two groups: control (n = 100) and cases (n = 100). The cases were further subdivided into; mild preeclampsia (n =46), and severe preeclampsia (n = 54). The study groups were well-matched in maternal age, gestational age and body mass index. Blood samples were taken for measurement of serum cancer antigen-CA125, uric acid and C - reactive protein using immune- assay and enzymatic automated chemical analysis.
Results: The mean levels of cancer antigen-CA125 in mild and severe preeclampsia groups were; 21.94±5.08 (IU/ml) and 40.77±9.82 (IU/ml) respectively, which were significantly higher, (P<0.001) in comparison with the control group (16.88±7.36 (IU/ml). The mean levels of C-reactive protein in mild and severe preeclampsia were; 15.17±5.35 (mg/L), 31.49±12.56 (mg/L) respectively. There was significant difference in their levels, compared to the control group (4.79±1.78 (mg/L), (P<0.01). Also, the mean levels of uric acid in mild and severe cases were; 6.44±1.98 and 7.37±2.00 which was significantly higher, in comparison with the control (4.00±0.61); (P<0.001). The level of uric acid also, showed significant difference within the case (severe and mild) group (P<0.05). CA125, CRP and UA levels correlated positively with Mean Arterial blood pressure (MAP), (r>0.7; P < 0.001). ROC curve validate the utility of these biomarker for the detection of preeclampsia severity (AUC>0. 8; P < 0.001).
Conclusion: Serum cancer antigen 125(CA125), C- reactive protein and uric acid in studied preeclampsia groups were found to be significantly higher compared with the control group, and the rises were directly associated with the severity of preeclampsia.
Keywords: Cancer antigen, C-reactive protein, uric acid, preeclampsia (PE), Sudan